Anaesthetic efficacy of 4% articaine and 2% lidocaine for extraction and pulpotomy of mandibular primary molars: an equivalence parallel prospective randomized controlled trial

Aim: To compare the anaesthetic efficacy for pain and behaviour during treatment with mandibular infiltration using 4% articaine (BI) with inferior dental nerve clock (IDNB) using 2% lidocaine for extraction or pulp therapy in mandibular primary molars.

Design: This was equivalence parallel prospective RCT. A total of 98 children aged 5–9 years old were randomly assigned into two groups: BI supplemented by buccal intrapapillary infiltration with 4% articaine; IDNB with 2% lidocaine supplemented with long buccal infiltration. Behaviour during the injection and treatment procedures was assessed using Wong‐Baker Facial Rating Scale (W‐BFRS), Visual Analogue Scale (VAS), and Frankl Behaviour Rating Scale (FBRS).

Results: During the injection phase, the absolute differences in success rates between the two techniques were 0.06 (95% CI: −0.11 to 0.23) for VAS and −0.08 (95% CI: −0.19 to 0.03) for the behaviour of the child (FBRS). FBRS results showed the equivalence of the two, whereas the VAS results showed nonequivalence with the 95% confidence intervals slightly exceeding the equivalence margin (±0.20). W‐BFRS success rates were 63.3% for both. During the treatment, VAS results showed similar success rates, demonstrating equivalence between the two as did the results for FBRS.

Conclusion: The results suggested equivalence in success rates for both anaesthetic techniques during treatment.