Comparative Evaluation of Anesthetic Efficacy of 4% Articaine and 2% Lignocaine as Inferior Alveolar Nerve Block in Patients With Symptomatic Irreversible Pulpitis in Permanent Mandibular First Molars: A Double-Blinded Randomized Clinical Trial
Bibliographic record
Abstract
INTRODUCTION: Achieving effective anesthesia during root canal treatment is particularly challenging in cases of symptomatic irreversible pulpitis due to the inflamed pulpal environment, which compromises anesthetic efficacy. Articaine and lignocaine are commonly used local anesthetics in endodontics, differing in onset time, duration, and pain control. The objective of this study was to compare the anesthetic efficacy of 2% lignocaine combined with 1:80,000 epinephrine with 4% articaine combined with 1:100,000 epinephrine during root canal treatment of permanent mandibular first molars in patients with symptomatic irreversible pulpitis. METHOD: 100 patients, 18-30 years old, with symptomatic irreversible pulpitis in permanent mandibular first molars without any periapical pathology reported to the Department of Conservative Dentistry and Endodontics, Regional Dental College, Guwahati. Following the provision of written informed consent, participants were randomly assigned to receive a conventional inferior alveolar nerve block using either 1.8 mL of 2% lignocaine with 1:80,000 epinephrine (n = 50) or 1.7 mL of 4% articaine with 1:100,000 epinephrine (n=50). Randomization was performed by an individual who did not take part in data acquisition. To avoid identification, the independent observer covered 50 cartridges containing 2% lignocaine and 50 cartridges containing 4% articaine with blue and pink colored tapes, respectively. Patients were subjectively assessed for lip anesthesia. Absence/presence of pulpal anesthesia was tested by using electric pulp stimulation, and absence/presence of pain was assessed by using a Short-Form McGill Pain Questionnaire (Appendix). Data were analyzed using IBM Corp. Released 2011. IBM SPSS Statistics for Windows, Version 20.0. Armonk, NY: IBM Corp., with the Student's paired t-test to compare outcomes between the groups. RESULTS: The articaine group showed a faster onset of anesthesia (4.3 min vs. 7.8 min), longer duration (120.8 ± 3 min vs. 64.9 ± 5.2 min), and better pain control during root canal treatment (mean pain score: 1.09 vs. 1.63) compared to the lignocaine group. These differences were statistically highly significant (p < 0.001). CONCLUSION: Articaine demonstrated faster onset, longer duration, and better pain control than lignocaine, making it a preferred choice for inferior alveolar nerve block in permanent mandibular first molars with symptomatic irreversible pulpitis.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.004 | 0.004 |
| Meta-epidemiology (narrow) | 0.002 | 0.001 |
| Meta-epidemiology (broad) | 0.006 | 0.002 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.002 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.003 | 0.002 |
| Insufficient payload (model declined to judge) | 0.006 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".