title: Comparison of anesthetic efficacy of 2 and 4 % articaine in inferior alveolar nerve block for tooth extraction-a double-blinded randomized clinical trial.
abstract: OBJECTIVE
  The purpose of this clinical prospective, randomized, double-blind trial was to compare the anesthetic efficacy of 2 % articaine and 4 % articaine in inferior alveolar nerve block anesthesia for extraction of mandibular teeth.
  
  
  METHODS
  In 95 patients, 105 lower molar and premolar teeth were extracted after intraoral inferior alveolar nerve block. In 53 cases, 2 % articaine (group I) and, in 52 cases, 4 % articaine (group II) was administered. The primary objective was to analyze the differences of anesthetic effects between the two groups (complete/sufficient vs. insufficient/none). Furthermore, differences in pulpal anesthesia (onset and depth, examined with pulp vitality tester (min)), as well as in length of soft tissue anesthesia (min), were evaluated. Additionally, the need of a second injection, pain while injecting (numeric rating scale (NRS)), pain during treatment (NRS), pain after treatment (NRS), and other possible complications (excessive pain, bleeding events, prolonged deafness) were analyzed.
  
  
  RESULTS
  Anesthesia was sufficient for dental extractions in both groups without significant differences (p = 0.201). The onset of anesthesia did not differ significantly (p = 0.297). A significantly shorter duration of soft tissue anesthesia was seen in group I (2.9 vs. 4 h; p < 0.001). There was no significant difference in the need for a second injection (p = 0.359), in injection pain (p = 0.386), as well as in pain during (p = 0.287) or after treatment (p = 0.121). In both groups, no complications were seen.
  
  
  CONCLUSIONS
  The local anesthetic effect of the 4 % articaine solution is not significantly better when compared to 2 % articaine.
  
  
  CONCLUSIONS
  For mandibular tooth extraction, articaine 2 % may be used as alternative as well.
authors.affiliation: Department of Oral, Maxillofacial and Plastic Surgery, University Medical Center Rostock, Schillingallee 35, 18057, Rostock, Germany. peer.kaemmerer@gmx.de.
authors.forename: P W
authors.initials: PW
authors.lastname: Kämmerer
authors.affiliation: HELIOS Clinics, Schwerin, Germany.
authors.forename: D
authors.initials: D
authors.lastname: Schneider
authors.affiliation: Laboratory of Tissue Engineering, State University of Medicine and Pharmacy "N. Testemitanu", Chisinau, Moldova.
authors.forename: V
authors.initials: V
authors.lastname: Palarie
authors.affiliation: Department of Oral, Maxillofacial and Plastic Surgery, University Medical Center Mainz, Mainz, Germany.
authors.forename: E
authors.initials: E
authors.lastname: Schiegnitz
authors.affiliation: Department of Oral Surgery, University Medical Centre Mainz, Mainz, Germany.
authors.forename: M
authors.initials: M
authors.lastname: Daubländer
mesh_terms: D000779:Anesthetics, Local / Q000008:administration & dosage*; D002355:Carticaine / Q000008:administration & dosage*; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D008297:Male; D008340:Mandibular Nerve; D009407:Nerve Block / Q000379:methods*; D010147:Pain Measurement; D011446:Prospective Studies; D014081:Tooth Extraction; D016896:Treatment Outcome
chemical_list: D000779:Anesthetics, Local; D002355:Carticaine
keywords: 2 %; 4 %; Articaine; Dental local anesthesia; Dental treatment; Epinephrine adjunct; Inferior alveolar nerve block; Tooth extraction