title: Efficacy and safety of articaine versus lidocaine for irreversible pulpitis treatment: A systematic review and meta-analysis of randomised controlled trials.
abstract: The aim was to assess the efficacy and safety of articaine compared with lidocaine for irreversible pulpitis (IP) treatment. Databases were explored electronically and relevant journals as well as the references of the included studies were hand-searched for randomised clinical trials comparing the efficacy and safety of articaine with lidocaine in treatment of IP. Twenty studies were included, of which eight had low risk of bias, 10 had moderate risk of bias and two had high risk of bias. In comparison with 2% lidocaine with 1:100,000 epinephrine, 4% articaine with 1:100,000 epinephrine showed a higher success rate in anaesthesia of IP at either person (risk ratio (RR) 1.15; 95% confidence intervals (CI) 1.10 1.20; P < 0.00001) or tooth unit (RR 1.10; 95% CI 1.10 1.19, P < 0.00001), lower VAS scores during injection phase (mean difference (MD) -0.67; 95% CI -1.26 -0.08, P = 0.02) and treatment phase (MD -3.35; 95% CI -3.78 -2.91, P < 0.00001), shorter onset time of pulpal anaesthesia (MD -0.94; 95% CI -1.13 -0.74, P < 0.00001) and lower percentage of patients undergoing adverse events (RR 0.17; 95% CI 0.03 0.92, P = 0.04). Given the efficacy and safety of the two solutions, 4% articaine with 1:100,000 epinephrine was superior to 2% lidocaine with 1:100,000 epinephrine in dental treatments in IP.
authors.affiliation: State Key Laboratory of Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China.|Department of Prosthodontics, West China College of Stomatology, Sichuan University, Chengdu, China.
authors.forename: Naichuan
authors.initials: N
authors.lastname: Su
authors.affiliation: State Key Laboratory of Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China.|Department of Oral and Maxillofacial Surgery, West China College of Stomatology, Sichuan University, Chengdu, China.
authors.forename: Chunjie
authors.initials: C
authors.lastname: Li
authors.affiliation: State Key Laboratory of Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China.|Department of Prosthodontics, West China College of Stomatology, Sichuan University, Chengdu, China.
authors.forename: Hang
authors.initials: H
authors.lastname: Wang
authors.affiliation: State Key Laboratory of Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China.|Department of Prosthodontics, West China College of Stomatology, Sichuan University, Chengdu, China.
authors.forename: Jiefei
authors.initials: J
authors.lastname: Shen
authors.affiliation: State Key Laboratory of Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China.|Department of Prosthodontics, West China College of Stomatology, Sichuan University, Chengdu, China.
authors.forename: Wenjia
authors.initials: W
authors.lastname: Liu
authors.affiliation: Department of Prosthodontics, Ningbo Dental Hospital, Ningbo, China.
authors.forename: Liang
authors.initials: L
authors.lastname: Kou
mesh_terms: D000766:Anesthesia, Dental; D000779:Anesthetics, Local / Q000627:therapeutic use*; D002355:Carticaine / Q000627:therapeutic use*; D006801:Humans; D008012:Lidocaine / Q000627:therapeutic use*; D011671:Pulpitis / Q000188:drug therapy*; D016032:Randomized Controlled Trials as Topic
chemical_list: D000779:Anesthetics, Local; D008012:Lidocaine; D002355:Carticaine
keywords: articaine; lidocaine; local anaesthesia; meta-analysis; pulpitis