title: The pulpal anesthetic efficacy of articaine versus lidocaine in dentistry: a meta-analysis.
abstract: BACKGROUND
  The authors evaluated published evidence from controlled clinical trials regarding the efficacy of two local anesthetic solutions in providing successful pulpal anesthesia.
  
  
  METHODS
  The authors searched MEDLINE and Embase databases to identify peer-reviewed randomized controlled trials in which researchers directly compared articaine and lidocaine local anesthetic solutions in adult participants. They extracted study characteristics and outcomes data as a basis for meta-analysis. They completed subgroup analyses for both infiltration and mandibular inferior alveolar block anesthetic techniques.
  
  
  RESULTS
  Articaine solutions had a probability of achieving anesthetic success superior to that of lidocaine, with an odds ratio of 2.44 (95 percent confidence interval [CI], 1.59-3.76; P < .0001). The greater odds ratio for articaine increased to 3.81 (95 percent CI, 2.71-5.36; P < .00001) when the authors analyzed only infiltration data. There was weaker, but still significant, evidence of articaine's being superior to lidocaine for mandibular block anesthesia, with an odds ratio of 1.57 (95 percent CI, 1.12-2.21; P = .009), and no difference when the authors considered only symptomatic teeth.
  
  
  CONCLUSIONS
  Research evidence supports using articaine versus lidocaine for achieving pulpal anesthesia when the infiltration mode of administration is used. It is premature to recommend articaine for mandibular block anesthesia in cases involving irreversible pulpitis.
authors.affiliation: Department of Cariology, Restorative Sciences and Endodontics, School of Dentistry, University of Michigan, Ann Arbor, MI, USA.
authors.forename: Ryan G
authors.initials: RG
authors.lastname: Brandt
authors.forename: Patricia F
authors.initials: PF
authors.lastname: Anderson
authors.forename: Neville J
authors.initials: NJ
authors.lastname: McDonald
authors.forename: Woosung
authors.initials: W
authors.lastname: Sohn
authors.forename: Mathilde C
authors.initials: MC
authors.lastname: Peters
mesh_terms: D000328:Adult; D000766:Anesthesia, Dental; D000772:Anesthesia, Local; D000779:Anesthetics, Local / Q000008:administration & dosage*; D002355:Carticaine / Q000008:administration & dosage*; D003782:Dental Pulp / Q000187:drug effects*; D006801:Humans; D007267:Injections; D008012:Lidocaine / Q000008:administration & dosage*; D008340:Mandibular Nerve; D009407:Nerve Block / Q000379:methods; D011336:Probability; D016032:Randomized Controlled Trials as Topic
chemical_list: D000779:Anesthetics, Local; D008012:Lidocaine; D002355:Carticaine