Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Meta-Analysis
. 2018 Jul 10;7(7):CD006487.
doi: 10.1002/14651858.CD006487.pub2.

Injectable local anaesthetic agents for dental anaesthesia

Geoffrey St George  1 , Alyn Morgan, John Meechan, David R Moles, Ian Needleman, Yuan-Ling Ng, Aviva Petrie
Affiliations
Meta-Analysis

Injectable local anaesthetic agents for dental anaesthesia

Geoffrey St George et al. Cochrane Database Syst Rev. .

Abstract

Background: Pain during dental treatment, which is a common fear of patients, can be controlled successfully by local anaesthetic. Several different local anaesthetic formulations and techniques are available to dentists.

Objectives: Our primary objectives were to compare the success of anaesthesia, the speed of onset and duration of anaesthesia, and systemic and local adverse effects amongst different local anaesthetic formulations for dental anaesthesia. We define success of anaesthesia as absence of pain during a dental procedure, or a negative response to electric pulp testing or other simulated scenario tests. We define dental anaesthesia as anaesthesia given at the time of any dental intervention.Our secondary objective was to report on patients' experience of the procedures carried out.

Search methods: We searched the Cochrane Central Register of Controlled Trials (CENTRAL; the Cochrane Library; 2018, Issue 1), MEDLINE (OVID SP), Embase, CINAHL PLUS, WEB OF SCIENCE, and other resources up to 31 January 2018. Other resources included trial registries, handsearched journals, conference proceedings, bibliographies/reference lists, and unpublished research.

Selection criteria: We included randomized controlled trials (RCTs) testing different formulations of local anaesthetic used for clinical procedures or simulated scenarios. Studies could apply a parallel or cross-over design.

Data collection and analysis: We used standard Cochrane methodological approaches for data collection and analysis.

Main results: We included 123 studies (19,223 participants) in the review. We pooled data from 68 studies (6615 participants) for meta-analysis, yielding 23 comparisons of local anaesthetic and 57 outcomes with 14 different formulations. Only 10 outcomes from eight comparisons involved clinical testing.We assessed the included studies as having low risk of bias in most domains. Seventy-three studies had at least one domain with unclear risk of bias. Fifteen studies had at least one domain with high risk of bias due to inadequate sequence generation, allocation concealment, masking of local anaesthetic cartridges for administrators or outcome assessors, or participant dropout or exclusion.We reported results for the eight most important comparisons.Success of anaesthesiaWhen the success of anaesthesia in posterior teeth with irreversible pulpitis requiring root canal treatment is tested, 4% articaine, 1:100,000 epinephrine, may be superior to 2% lidocaine, 1:100,000 epinephrine (31% with 2% lidocaine vs 49% with 4% articaine; risk ratio (RR) 1.60, 95% confidence interval (CI) 1.10 to 2.32; 4 parallel studies; 203 participants; low-quality evidence).When the success of anaesthesia for teeth/dental tissues requiring surgical procedures and surgical procedures/periodontal treatment, respectively, was tested, 3% prilocaine, 0.03 IU felypressin (66% with 3% prilocaine vs 76% with 2% lidocaine; RR 0.86, 95% CI 0.79 to 0.95; 2 parallel studies; 907 participants; moderate-quality evidence), and 4% prilocaine plain (71% with 4% prilocaine vs 83% with 2% lidocaine; RR 0.86, 95% CI 0.75 to 0.99; 2 parallel studies; 228 participants; low-quality evidence) were inferior to 2% lidocaine, 1:100,000 epinephrine.Comparative effects of 4% articaine, 1:100,000 epinephrine and 4% articaine, 1:200,000 epinephrine on success of anaesthesia for teeth/dental tissues requiring surgical procedures are uncertain (RR 0.85, 95% CI 0.71 to 1.02; 3 parallel studies; 930 participants; very low-quality evidence).Comparative effects of 0.5% bupivacaine, 1:200,000 epinephrine and both 4% articaine, 1:200,000 epinephrine (odds ratio (OR) 0.87, 95% CI 0.27 to 2.83; 2 cross-over studies; 37 participants; low-quality evidence) and 2% lidocaine, 1:100,000 epinephrine (OR 0.58, 95% CI 0.07 to 5.12; 2 cross-over studies; 31 participants; low-quality evidence) on success of anaesthesia for teeth requiring extraction are uncertain.Comparative effects of 2% mepivacaine, 1:100,000 epinephrine and both 4% articaine, 1:100,000 epinephrine (OR 3.82, 95% CI 0.61 to 23.82; 1 parallel and 1 cross-over study; 110 participants; low-quality evidence) and 2% lidocaine, 1:100,000 epinephrine (RR 1.16, 95% CI 0.25 to 5.45; 2 parallel studies; 68 participants; low-quality evidence) on success of anaesthesia for teeth requiring extraction and teeth with irreversible pulpitis requiring endodontic access and instrumentation, respectively, are uncertain.For remaining outcomes, assessing success of dental local anaesthesia via meta-analyses was not possible.Onset and duration of anaesthesiaFor comparisons assessing onset and duration, no clinical studies met our outcome definitions.Adverse effects (continuous pain measured on 170-mm Heft-Parker visual analogue scale (VAS))Differences in post-injection pain between 4% articaine, 1:100,000 epinephrine and 2% lidocaine, 1:100,000 epinephrine are small, as measured on a VAS (mean difference (MD) 4.74 mm, 95% CI -1.98 to 11.46 mm; 3 cross-over studies; 314 interventions; moderate-quality evidence). Lidocaine probably resulted in slightly less post-injection pain than articaine (MD 6.41 mm, 95% CI 1.01 to 11.80 mm; 3 cross-over studies; 309 interventions; moderate-quality evidence) on the same VAS.For remaining comparisons assessing local and systemic adverse effects, meta-analyses were not possible. Other adverse effects were rare and minor.Patients' experiencePatients' experience of procedures was not assessed owing to lack of data.

Authors' conclusions: For success (absence of pain), low-quality evidence suggests that 4% articaine, 1:100,000 epinephrine was superior to 2% lidocaine, 1:100,000 epinephrine for root treating of posterior teeth with irreversible pulpitis, and 2% lidocaine, 1:100,000 epinephrine was superior to 4% prilocaine plain when surgical procedures/periodontal treatment was provided. Moderate-quality evidence shows that 2% lidocaine, 1:100,000 epinephrine was superior to 3% prilocaine, 0.03 IU felypressin when surgical procedures were performed.Adverse events were rare. Moderate-quality evidence shows no difference in pain on injection when 4% articaine, 1:100,000 epinephrine and 2% lidocaine, 1:100,000 epinephrine were compared, although lidocaine resulted in slightly less pain following injection.Many outcomes tested our primary objectives in simulated scenarios, although clinical alternatives may not be possible.Further studies are needed to increase the strength of the evidence. These studies should be clearly reported, have low risk of bias with adequate sample size, and provide data in a format that will allow meta-analysis. Once assessed, results of the 34 'Studies awaiting classification (full text unavailable)' may alter the conclusions of the review.

PubMed Disclaimer

Conflict of interest statement

Geoffrey St George: none known.

Alyn Morgan: none known.

John Meechan previously received research funding from Septodont, Astra, and Dentsply. At present, he has no research funding from any companies and will not be receiving any funding for this review. He was an author on three of the primary studies included in this review (Jaber 2010; Kanaa 2006; Kanaa 2012). Data for these studies were extracted by GSG and AM.

David R Moles: none known.

Ian Needleman: none known.

Yuan‐Ling Ng: none known.

Aviva Petrie: none known.

Figures

1
1
Study flow diagram.
2
2
Risk of bias graph: review authors' judgements about each risk of bias item presented as percentages across all included studies.
3
3
Risk of bias summary: review authors' judgements about each risk of bias item for each included study.
1.1
1.1. Analysis
Comparison 1 4% articaine, 1:100,000 epinephrine vs 2% lidocaine, 1:100,000 epinephrine, Outcome 1 Success of local anaesthesia, measured by the absence of pain during a procedure using a visual analogue scale or other appropriate method (clinical testing of diseased pulps with irreversible pulpitis).
1.2
1.2. Analysis
Comparison 1 4% articaine, 1:100,000 epinephrine vs 2% lidocaine, 1:100,000 epinephrine, Outcome 2 Success of local anaesthesia, measured by the absence of pain during a procedure using a visual analogue scale (VAS) or other appropriate method (simulated scenario testing of healthy pulps).
1.3
1.3. Analysis
Comparison 1 4% articaine, 1:100,000 epinephrine vs 2% lidocaine, 1:100,000 epinephrine, Outcome 3 Success of local anaesthesia, measured by the absence of pain during a procedure using a visual analogue scale (VAS) or other appropriate method (simulated scenario testing of soft tissues).
1.4
1.4. Analysis
Comparison 1 4% articaine, 1:100,000 epinephrine vs 2% lidocaine, 1:100,000 epinephrine, Outcome 4 Speed of onset of anaesthesia (simulated scenario testing of healthy pulps).
1.5
1.5. Analysis
Comparison 1 4% articaine, 1:100,000 epinephrine vs 2% lidocaine, 1:100,000 epinephrine, Outcome 5 Duration of anaesthesia (simulated scenario testing of healthy pulps).
1.6
1.6. Analysis
Comparison 1 4% articaine, 1:100,000 epinephrine vs 2% lidocaine, 1:100,000 epinephrine, Outcome 6 Speed of onset of anaesthesia (simulated scenario testing of soft tissues).
1.7
1.7. Analysis
Comparison 1 4% articaine, 1:100,000 epinephrine vs 2% lidocaine, 1:100,000 epinephrine, Outcome 7 Duration of anaesthesia (simulated scenario testing of soft tissues).
1.8
1.8. Analysis
Comparison 1 4% articaine, 1:100,000 epinephrine vs 2% lidocaine, 1:100,000 epinephrine, Outcome 8 Local adverse effects, pain on injection.
1.9
1.9. Analysis
Comparison 1 4% articaine, 1:100,000 epinephrine vs 2% lidocaine, 1:100,000 epinephrine, Outcome 9 Local adverse effects, pain following injection.
2.1
2.1. Analysis
Comparison 2 3% prilocaine, 0.03 IU felypressin vs 2% lidocaine, 1:100,000 epinephrine, Outcome 1 Success of local anaesthesia, measured by the absence of pain during a procedure using a visual analogue scale or other appropriate method (clinical testing of healthy pulps, hard and soft tissues).
3.1
3.1. Analysis
Comparison 3 4% articaine, 1:200,000 epinephrine vs 4% articaine, 1:100,000 epinephrine, Outcome 1 Success of local anaesthesia, measured by the absence of pain during a procedure using a visual analogue scale or other appropriate method (clinical testing of healthy pulps, hard and soft tissues).
3.2
3.2. Analysis
Comparison 3 4% articaine, 1:200,000 epinephrine vs 4% articaine, 1:100,000 epinephrine, Outcome 2 Success of local anaesthesia, measured by the absence of pain during a procedure using a visual analogue scale (VAS) or other appropriate method (simulated scenario testing of healthy pulps).
3.3
3.3. Analysis
Comparison 3 4% articaine, 1:200,000 epinephrine vs 4% articaine, 1:100,000 epinephrine, Outcome 3 Speed of onset of anaesthesia (simulated scenario testing of healthy pulps).
3.4
3.4. Analysis
Comparison 3 4% articaine, 1:200,000 epinephrine vs 4% articaine, 1:100,000 epinephrine, Outcome 4 Duration of anaesthesia (simulated scenario testing of healthy pulps).
4.1
4.1. Analysis
Comparison 4 4% prilocaine plain vs 2% lidocaine 1:100,000 epinephrine, Outcome 1 Success of local anaesthesia, measured by the absence of pain during a procedure using a visual analogue scale or other appropriate method (clinical testing of healthy pulps, hard and soft tissues).
4.2
4.2. Analysis
Comparison 4 4% prilocaine plain vs 2% lidocaine 1:100,000 epinephrine, Outcome 2 Success of local anaesthesia, measured by the absence of pain during a procedure using a visual analogue scale (VAS) or other appropriate method (simulated scenario testing of healthy pulps).
4.3
4.3. Analysis
Comparison 4 4% prilocaine plain vs 2% lidocaine 1:100,000 epinephrine, Outcome 3 Speed of onset of anaesthesia (simulated scenario testing of healthy pulps).
4.4
4.4. Analysis
Comparison 4 4% prilocaine plain vs 2% lidocaine 1:100,000 epinephrine, Outcome 4 Speed of onset of anaesthesia (simulated scenario testing of soft tissues).
4.5
4.5. Analysis
Comparison 4 4% prilocaine plain vs 2% lidocaine 1:100,000 epinephrine, Outcome 5 Duration of anaesthesia (simulated scenario testing of soft tissues).
5.1
5.1. Analysis
Comparison 5 0.5% bupivacaine, 1:200,000 epinephrine vs 4% articaine, 1:200,000 epinephrine, Outcome 1 Success of local anaesthesia, measured by the absence of pain during a procedure using a visual analogue scale or other appropriate method (clinical testing of healthy pulps, hard and soft tissues).
5.2
5.2. Analysis
Comparison 5 0.5% bupivacaine, 1:200,000 epinephrine vs 4% articaine, 1:200,000 epinephrine, Outcome 2 Speed of onset of anaesthesia (simulated scenario testing of soft tissues).
5.3
5.3. Analysis
Comparison 5 0.5% bupivacaine, 1:200,000 epinephrine vs 4% articaine, 1:200,000 epinephrine, Outcome 3 Duration of anaesthesia (simulated scenario testing of soft tissues).
6.1
6.1. Analysis
Comparison 6 0.5% bupivacaine, 1:200,000 epinephrine vs 2% lidocaine, 1:100,000 epinephrine, Outcome 1 Success of local anaesthesia, measured by the absence of pain during a procedure using a visual analogue scale (VAS) or other appropriate method (clinical testing of healthy pulps, hard and soft tissues).
6.2
6.2. Analysis
Comparison 6 0.5% bupivacaine, 1:200,000 epinephrine vs 2% lidocaine, 1:100,000 epinephrine, Outcome 2 Success of local anaesthesia, measured by the absence of pain during a procedure using a visual analogue scale or other appropriate method (simulated scenario testing of healthy pulps).
6.3
6.3. Analysis
Comparison 6 0.5% bupivacaine, 1:200,000 epinephrine vs 2% lidocaine, 1:100,000 epinephrine, Outcome 3 Speed of onset of anaesthesia (simulated scenario testing of healthy pulps).
6.4
6.4. Analysis
Comparison 6 0.5% bupivacaine, 1:200,000 epinephrine vs 2% lidocaine, 1:100,000 epinephrine, Outcome 4 Speed of onset of anaesthesia (simulated scenario testing of soft tissues).
6.5
6.5. Analysis
Comparison 6 0.5% bupivacaine, 1:200,000 epinephrine vs 2% lidocaine, 1:100,000 epinephrine, Outcome 5 Duration of anaesthesia (simulated scenario testing of soft tissues).
7.1
7.1. Analysis
Comparison 7 4% articaine, 1:100,000 epinephrine vs 2% mepivacaine, 1:100,000 epinephrine, Outcome 1 Success of local anaesthesia, measured by the absence of pain during a procedure using a visual analogue scale or other appropriate method (clinical testing of healthy pulps, hard and soft tissues).
7.2
7.2. Analysis
Comparison 7 4% articaine, 1:100,000 epinephrine vs 2% mepivacaine, 1:100,000 epinephrine, Outcome 2 Success of local anaesthesia, measured by the absence of pain during a procedure using a visual analogue scale (VAS) or other appropriate method (simulated scenario testing of soft tissues).
8.1
8.1. Analysis
Comparison 8 2% lidocaine, 1:100,000 epinephrine vs 2% mepivacaine, 1:100,000 epinephrine, Outcome 1 Success of local anaesthesia, measured by the absence of pain during a procedure using a visual analogue scale or other appropriate method (clinical testing of diseased pulps with irreversible pulpitis).
9.1
9.1. Analysis
Comparison 9 2% lidocaine, 1:50,000 epinephrine vs 2% lidocaine, 1:80,000 epinephrine, Outcome 1 Success of local anaesthesia, measured by the absence of pain during a procedure using a visual analogue scale (VAS) or other appropriate method (simulated scenario testing of healthy pulps).
10.1
10.1. Analysis
Comparison 10 2% lidocaine, 1:50,000 epinephrine vs 2% lidocaine, 1:100,000 epinephrine, Outcome 1 Success of local anaesthesia, measured by the absence of pain during a procedure using a visual analogue scale (VAS) or other appropriate method (simulated scenario testing of healthy pulps).
10.2
10.2. Analysis
Comparison 10 2% lidocaine, 1:50,000 epinephrine vs 2% lidocaine, 1:100,000 epinephrine, Outcome 2 Speed of onset of anaesthesia (simulated scenario testing of healthy pulps).
11.1
11.1. Analysis
Comparison 11 2% lidocaine, 1:80,000 epinephrine vs 2% lidocaine, 1:100,000 epinephrine, Outcome 1 Success of local anaesthesia, measured by the absence of pain during a procedure using a visual analogue scale (VAS) or other appropriate method (simulated scenario testing of healthy pulps).
12.1
12.1. Analysis
Comparison 12 2% lidocaine, 1:200,000 epinephrine vs 2% lidocaine, 1:100,000 epinephrine, Outcome 1 Success of local anaesthesia, measured by the absence of pain during a procedure using a visual analogue scale (VAS) or other appropriate method (simulated scenario testing of healthy pulps).
13.1
13.1. Analysis
Comparison 13 3% mepivacaine plain vs 2% lidocaine, 1:100,000 epinephrine, Outcome 1 Success of local anaesthesia, measured by the absence of pain during a procedure using a visual analogue scale (VAS) or other appropriate method (simulated scenario testing of healthy pulps).
13.2
13.2. Analysis
Comparison 13 3% mepivacaine plain vs 2% lidocaine, 1:100,000 epinephrine, Outcome 2 Speed of onset of anaesthesia (simulated scenario testing of healthy pulps).
14.1
14.1. Analysis
Comparison 14 3% mepivacaine plain vs 2% lidocaine, 1:50,000 epinephrine, Outcome 1 Success of local anaesthesia, measured by the absence of pain during a procedure using a visual analogue scale (VAS) or other appropriate method (simulated scenario testing of healthy pulps).
14.2
14.2. Analysis
Comparison 14 3% mepivacaine plain vs 2% lidocaine, 1:50,000 epinephrine, Outcome 2 Speed of onset of anaesthesia (simulated scenario testing of healthy pulps).
15.1
15.1. Analysis
Comparison 15 2% mepivacaine, 1:20,000 levonordefrin vs 2% lidocaine, 1:100,000 epinephrine, Outcome 1 Duration of anaesthesia (simulated scenario testing of soft tissues).
16.1
16.1. Analysis
Comparison 16 4% articaine, 1:200,000 epinephrine vs 2% lidocaine, 1:100,000 epinephrine, Outcome 1 Success of local anaesthesia, measured by the absence of pain during a procedure using a visual analogue scale (VAS) or other appropriate method (simulated scenario testing of healthy pulps).
16.2
16.2. Analysis
Comparison 16 4% articaine, 1:200,000 epinephrine vs 2% lidocaine, 1:100,000 epinephrine, Outcome 2 Speed of onset of anaesthesia (simulated scenario testing of healthy pulps).
16.3
16.3. Analysis
Comparison 16 4% articaine, 1:200,000 epinephrine vs 2% lidocaine, 1:100,000 epinephrine, Outcome 3 Duration of anaesthesia (simulated scenario testing of healthy pulps).
17.1
17.1. Analysis
Comparison 17 4% articaine, 1:100,000 epinephrine vs 2% lidocaine, 1:80,000 epinephrine, Outcome 1 Speed of onset of anaesthesia (simulated scenario testing of soft tissues).
18.1
18.1. Analysis
Comparison 18 4% articaine, 1:200,000 epinephrine vs 4% prilocaine, 1:200,000 epinephrine, Outcome 1 Success of local anaesthesia, measured by the absence of pain during a procedure using a visual analogue scale (VAS) or other appropriate method (simulated scenario testing of healthy pulps).
19.1
19.1. Analysis
Comparison 19 4% prilocaine, 1:200,000 epinephrine vs 2% lidocaine, 1:100,000 epinephrine, Outcome 1 Success of local anaesthesia, measured by the absence of pain during a procedure using a visual analogue scale (VAS) or other appropriate method (simulated scenario testing of healthy pulps).
19.2
19.2. Analysis
Comparison 19 4% prilocaine, 1:200,000 epinephrine vs 2% lidocaine, 1:100,000 epinephrine, Outcome 2 Speed of onset of anaesthesia (simulated scenario testing of healthy pulps).
19.3
19.3. Analysis
Comparison 19 4% prilocaine, 1:200,000 epinephrine vs 2% lidocaine, 1:100,000 epinephrine, Outcome 3 Speed of onset of anaesthesia (simulated scenario testing of soft tissues).
19.4
19.4. Analysis
Comparison 19 4% prilocaine, 1:200,000 epinephrine vs 2% lidocaine, 1:100,000 epinephrine, Outcome 4 Duration of anaesthesia (simulated scenario testing of soft tissues).
20.1
20.1. Analysis
Comparison 20 4% articaine plain vs 4% articaine, 1:100,000 epinephrine, Outcome 1 Success of local anaesthesia, measured by the absence of pain during a procedure using a visual analogue scale (VAS) or other appropriate method (simulated scenario testing of healthy pulps).
20.2
20.2. Analysis
Comparison 20 4% articaine plain vs 4% articaine, 1:100,000 epinephrine, Outcome 2 Speed of onset of anaesthesia (simulated scenario testing of healthy pulps).
20.3
20.3. Analysis
Comparison 20 4% articaine plain vs 4% articaine, 1:100,000 epinephrine, Outcome 3 Duration of anaesthesia (simulated scenario testing of healthy pulps).
21.1
21.1. Analysis
Comparison 21 4% articaine plain vs 4% articaine, 1:200,000 epinephrine, Outcome 1 Success of local anaesthesia, measured by the absence of pain during a procedure using a visual analogue scale (VAS) or other appropriate method (simulated scenario testing of healthy pulps).
21.2
21.2. Analysis
Comparison 21 4% articaine plain vs 4% articaine, 1:200,000 epinephrine, Outcome 2 Speed of onset of anaesthesia (simulated scenario testing of healthy pulps).
21.3
21.3. Analysis
Comparison 21 4% articaine plain vs 4% articaine, 1:200,000 epinephrine, Outcome 3 Duration of anaesthesia (simulated scenario testing of healthy pulps).
22.1
22.1. Analysis
Comparison 22 4% prilocaine, 1:200,000 epinephrine vs 4% prilocaine plain, Outcome 1 Duration of anaesthesia (simulated scenario testing of soft tissues).
23.1
23.1. Analysis
Comparison 23 4% articaine, 1:100,000 epinephrine vs 4% prilocaine, 1:200,000 epinephrine, Outcome 1 Success of local anaesthesia, measured by the absence of pain during a procedure using a visual analogue scale (VAS) or other appropriate method (simulated scenario testing of healthy pulps).
See this image and copyright information in PMC

Comment in

References

References to studies included in this review

Abdulwahab 2009 {published data only}
    1. Abdulwahab M, Boynes S, Moore P, Seifikar S, Al‐Jazzaf A, Alshuraidah A, et al. The efficacy of six local anesthetic formulations used for posterior mandibular buccal infiltration anesthesia. Journal of the American Dental Association 2009;140(8):1018‐24. [PUBMED: 19654255] - PubMed
Aggarwal 2009 {published data only}
    1. Aggarwal V, Jain A, Kabi D. Anesthetic efficacy of supplemental buccal and lingual infiltrations of articaine and lidocaine after an inferior alveolar nerve block in patients with irreversible pulpitis. Journal of Endodontics 2009;35(7):925‐9. [PUBMED: 19567309] - PubMed
Aggarwal 2014 {published data only}
    1. Aggarwal V, Singla M, Miglani S, Kohli S. Comparison of the anaesthetic efficacy of epinephrine concentrations (1:80,000 and 1:200,000) in 2% lidocaine for inferior alveolar nerve block in patients with symptomatic irreversible pulpitis: a randomized, double‐blind clinical trial. International Endodontic Journal 2014;47(4):373‐9. [PUBMED: 23895176] - PubMed
Aggarwal 2017 {published data only}
    1. Aggarwal V, Singla M, Miglani S. Comparative evaluation of anesthetic efficacy of 2% lidocaine, 4% articaine, and 0.5% bupivacaine on inferior alveolar nerve block in patients with symptomatic irreversible pulpitis: a prospective, randomized, double‐blind clinical trial. Journal of Oral & Facial Pain and Headache 2017;31(2):124‐8. [DOI: 10.11607/ofph.1642] - DOI - PubMed
Albertson 1963 {published data only}
    1. Albertson GL. Mepivacaine HCl in dental surgery. Dental Progress 1963;4(1):56‐9.
Allegretti 2016 {published data only}
    1. Allegretti CE, Sampaio RM, Horliana AC, Armonia PL, Rocha RG, Tortamano IP. Anesthetic efficacy in irreversible pulpitis: a randomized clinical trial. Brazilian Dental Journal 2016;27(4):381‐6. [EMBASE: 614935231] - PubMed
Arrow 2012 {published data only}
    1. Arrow P. A comparison of articaine 4% and lignocaine 2% in block and infiltration analgesia in children. Australian Dental Journal 2012;57(3):325‐33. [PUBMED: 22924356 ] - PubMed
Ashraf 2013 {published data only}
    1. Ashraf H, Kazem M, Dianat O, Noghrehkar F. Efficacy of articaine versus lidocaine in block and infiltration anesthesia administered in teeth with irreversible pulpitis: a prospective, randomized, double‐blind study. Journal of Endodontics 2013;39(1):6‐10. [PUBMED: 23228249] - PubMed
Atasoy Ulusoy 2014 {published data only}
    1. Atasoy Ulusoy Öİ, Alaçam T. Efficacy of single buccal infiltrations for maxillary first molars in patients with irreversible pulpitis: a randomized controlled clinical trial. International Endodontic Journal 2014;47(3):222‐7. [PUBMED: 23656209] - PubMed
Batista da Silva 2010 {published data only}
    1. Batista da Silva C, Berto LA, Volpato MC, Ramacciato JC, Motta RH, Ranali J, et al. Anesthetic efficacy of articaine and lidocaine for incisive/mental nerve block. Journal of Endodontics 2010;36(3):438‐41. [PUBMED: 20171359] - PubMed
Berberich 2009 {published data only}
    1. Berberich G, Reader A, Drum M, Nusstein J, Beck M. A prospective, randomized, double‐blind comparison of the anesthetic efficacy of two percent lidocaine with 1:100,000 and 1:50,000 epinephrine and three percent mepivacaine in the intraoral, infraorbital nerve block. Journal of Endodontics 2009;35(11):1498‐504. [PUBMED: 19840637] - PubMed
Bhagat 2014 {published data only}
    1. Bhagat MJ, Narayan V, Muthusekhar MR, Jain AR. Comparative study of the anesthetic efficacy of 4% articaine versus 2% Lignocaine in the inferior alveolar nerve block during the surgical extraction of impacted mandibular third molars. Universal Research Journal of Dentistry 2014;4(2):108‐14. [DOI: 10.4103/2249-9725.132975] - DOI
Bortoluzzi 2009 {published data only}
    1. Bortoluzzi MC, Manfro R, Kafer GC, Busetti LF. Comparative study of the efficacy of articaine and mepivacaine: a double‐blind, randomized, clinical trial. Internet Journal of Dental Science 2009;7(1):14p. [MEDLINE: ]
Bouloux 1999 {published data only}
    1. Bouloux GF, Punnia‐Moorthy A. Bupivacaine versus lidocaine for third molar surgery: a double‐blind, randomized, crossover study. Journal of Oral & Maxillofacial Surgery 1999;57(5):510‐4; discussion 515. [PUBMED: 10319823] - PubMed
Bradley 1969 {published data only}
    1. Bradley DJ, Martin ND. Clinical evaluation of mepivacaine and lidocaine. Australian Dental Journal 1969;14(6):377‐81. [MEDLINE: ] - PubMed
Burns 2004 {published data only}
    1. Burns Y, Reader A, Nusstein J, Beck M, Weaver J. Anesthetic efficacy of the palatal‐anterior superior alveolar injection. Journal of the American Dental Association 2004;135(9):1269‐76. [PUBMED: 15493391] - PubMed
Caldas 2015 {published data only}
    1. Caldas CS, Bergamaschi C, Succi G, Motta R, Ramacciato JC. Clinical evaluation of different epinephrine concentrations for local dental anesthesia. Revista Dor 2015;16(1):1‐5. [DOI: 10.5935/1806-0013.20150001] - DOI
Chapman 1988 {published data only}
    1. Chapman PJ. A controlled comparison of effectiveness of bupivacaine for post‐operative pain control. Australian Dental Journal 1988;33(4):288‐90. [PUBMED: 3075452] - PubMed
Chilton 1971 {published data only}
    1. Chilton NW. Clinical evaluation of prilocaine hydrochloride 4 percent solution with and without epinephrine. Journal of the American Dental Association 1971;83(1):149‐54. [PUBMED: 5281166] - PubMed
Claffey 2004 {published data only}
    1. Claffey E, Reader A, Nusstein J, Beck M, Weaver J. Anesthetic efficacy of articaine for inferior alveolar nerve blocks in patients with irreversible pulpitis. Journal of Endodontics 2004;30(8):568‐71. [PUBMED: 15273637] - PubMed
Cohen 1993 {published data only}
    1. Cohen HP, Cha BY, Spangberg LS. Endodontic anesthesia in mandibular molars: a clinical study. Journal of Endodontics 1993;19(7):370‐3. [PUBMED: 8245762] - PubMed
Colombini 2006 {published data only}
    1. Colombini BL, Modena KC, Calvo AM, Sakai VT, Giglio FP, Dionisio TJ, et al. Articaine and mepivacaine efficacy in postoperative analgesia for lower third molar removal: a double‐blind, randomized, crossover study. Oral Surgery Oral Medicine Oral Pathology Oral Radiology & Endodontics 2006;102(2):169‐74. [PUBMED: 16876058] - PubMed
Costa 2005 {published data only}
    1. Costa CG, Tortamano IP, Rocha RG, Francischone CE, Tortamano N. Onset and duration periods of articaine and lidocaine on maxillary infiltration. Quintessence International 2005;36(3):197‐201. [PUBMED: 15887505] - PubMed
Dagher 1997 {published data only}
    1. Dagher FB, Yared GM, Machtou P. An evaluation of 2% lidocaine with different concentrations of epinephrine for inferior alveolar nerve block. Journal of Endodontics 1997;23(3):178‐80. [PUBMED: 9594760] - PubMed
Donaldson 1987 {published data only}
    1. Donaldson D, James‐Perdok L, Craig BJ, Derkson GD, Richardson AS. A comparison of Ultracaine DS (articaine HCl) and Citanest forte (prilocaine HCl) in maxillary infiltration and mandibular nerve block. Journal (Canadian Dental Association) 1987;53(1):38‐42. [PUBMED: 3545401] - PubMed
Elbay 2016 {published data only}
    1. Elbay ÜŞ, Elbay M, Kaya E, Yıldırım S. Effects of two different anesthetic solutions on injection pain, efficacy, and duration of soft‐tissue anesthesia with inferior alveolar nerve block for primary molars. Journal of Clinical Pediatric Dentistry 2016;40(6):456‐63. [EMBASE: 616640618] - PubMed
Epstein 1965 {published data only}
    1. Epstein S. Clinical comparison of a new local anesthetic, propitocaine, with lidocaine. Journal of Oral Therapeutics & Pharmacology 1965;2(3):161‐70. [PUBMED: 5321605] - PubMed
Epstein 1969 {published data only}
    1. Epstein S. Clinical study of prilocaine with varying concentrations of epinephrine. Journal of the American Dental Association 1969;78(1):85‐90. [PUBMED: 5248313] - PubMed
Evans 2008 {published data only}
    1. Evans G, Nusstein J, Drum M, Reader A, Beck M. A prospective, randomized, double‐blind comparison of articaine and lidocaine for maxillary infiltrations. Journal of Endodontics 2008;34(4):389‐93. [PUBMED: 18358883] - PubMed
Fernandez 2005 {published data only}
    1. Fernandez C, Reader A, Beck M, Nusstein J. A prospective, randomized, double‐blind comparison of bupivacaine and lidocaine for inferior alveolar nerve blocks. Journal of Endodontics 2005;31(7):499‐503. [PUBMED: 15980707] - PubMed
Fertig 1968 {published data only}
    1. Fertig JW, Chilton NW. A dental local anaesthetic study. Fixed model, two‐way layout design. Archives of Oral Biology 1968;13(12):1477‐89. [PUBMED: 4885681] - PubMed
Forloine 2010 {published data only}
    1. Forloine A, Drum M, Reader A, Nusstein J, Beck M. A prospective, randomized, double‐blind comparison of the anesthetic efficacy of two percent lidocaine with 1:100,000 epinephrine and three percent mepivacaine in the maxillary high tuberosity second division nerve block. Journal of Endodontics 2010;36(11):1770‐7. [PUBMED: 20951285] - PubMed
Gangarosa 1967 {published data only}
    1. Gangarosa LP, Halik FJ. A clinical evaluation of local anaesthetic solutions containing graded epinephrine concentrations. Archives of Oral Biology 1967;12(5):611‐21. [PUBMED: 5336946] - PubMed
Gazal 2015 {published data only}
    1. Gazal G, Alharbi AM, Al‐Samadani K, Kanaa MD. Articaine and mepivacaine buccal infiltration in securing mandibular first molar pulp anesthesia following mepivacaine inferior alveolar nerve block: a randomized, double‐blind crossover study. Saudi Journal of Anaesthesia 2015;9(4):397‐403. [EMBASE: 2015443802] - PMC - PubMed
Gazal 2017 {published data only}
    1. Gazal G, Alharbi R, Fareed WM, Omar E, Alolayan AB, Al‐Zoubi H, et al. Comparison of onset anesthesia time and injection discomfort of 4% articaine and 2% mepivacaine during teeth extractions. Saudi Journal of Anaesthesia 2017;11(2):152‐7. [EMBASE: 615606206] - PMC - PubMed
Gregorio 2008 {published data only}
    1. Gregorio LV, Giglio FP, Sakai VT, Modena KC, Colombini BL, Calvo AM, et al. A comparison of the clinical anesthetic efficacy of 4% articaine and 0.5% bupivacaine (both with 1:200,000 epinephrine) for lower third molar removal. Oral Surgery Oral Medicine Oral Pathology Oral Radiology & Endodontics 2008;106(1):19‐28. [PUBMED: 18420431 ] - PubMed
Gross 2007 {published data only}
    1. Gross R, McCartney M, Reader A, Beck M. A prospective, randomized, double‐blind comparison of bupivacaine and lidocaine for maxillary infiltrations. Journal of Endodontics 2007;33(9):1021‐4. [PUBMED: 17931925] - PubMed
Haas 1990 {published data only}
    1. Haas DA, Harper DG, Saso MA, Young ER. Comparison of articaine and prilocaine anesthesia by infiltration in maxillary and mandibular arches. Anesthesia Progress 1990;37(5):230‐7. [PUBMED: 2096746] - PMC - PubMed
Haas 1991 {published data only}
    1. Haas DA, Harper DG, Saso MA, Young ER. Lack of differential effect by Ultracaine (articaine) and Citanest (prilocaine) in infiltration anaesthesia. Journal (Canadian Dental Association). 1991;57(3):217‐23. [PUBMED: 2043997] - PubMed
Haase 2008 {published data only}
    1. Haase A, Reader A, Nusstein J, Beck M, Drum M. Comparing anesthetic efficacy of articaine versus lidocaine as a supplemental buccal infiltration of the mandibular first molar after an inferior alveolar nerve block.[erratum appears in J Am Dent Assoc. 2008 Oct;139(10):1312]. Journal of the American Dental Association 2008;139(9):1228‐35. [PUBMED: 18762633] - PubMed
Hellden 1974 {published data only}
    1. Hellden L, Blomberg S, Woxberg B, Ohman A. A controlled trial of a long‐acting local anaesthetic (Marcaine) in oral surgery for relief of post‐operative pain. Svensk Tandlakaretidskrift 1974;67(4):223‐8. [PUBMED: 4606108] - PubMed
Hersh 1995 {published data only}
    1. Hersh EV, Hermann DG, Lamp CJ, Johnson PD, MacAfee KA. Assessing the duration of mandibular soft tissue anesthesia. Journal of the American Dental Association 1995;126(11):1531‐6. [PUBMED: 7499650] - PubMed
Hinkley 1991 {published data only}
    1. Hinkley SA, Reader A, Beck M, Meyers WJ. An evaluation of 4% prilocaine with 1:200,000 epinephrine and 2% mepivacaine with 1:20,000 levonordefrin compared with 2% lidocaine with 1:100,000 epinephrine for inferior alveolar nerve block. Anesthesia Progress 1991;38(3):84‐9. [PUBMED: 1814249] - PMC - PubMed
Hosseini 2016 {published data only}
    1. Hosseini HR, Parirokh M, Nakhaee N, Abbott PV, Samani S. Efficacy of articaine and lidocaine for buccal infiltration of first maxillary molars with symptomatic irreversible pulpitis: a randomized double‐blinded clinical trial. Iranian Endodontic Journal 2016;11(2):79‐84. [DOI: 10.7508/iej.2016.02.001] - DOI - PMC - PubMed
Jaber 2010 {published data only}
    1. Jaber A, Whitworth JM, Corbett IP, Al‐Baqshi B, Kanaa MD, Meechan JG. The efficacy of infiltration anaesthesia for adult mandibular incisors: a randomised double‐blind cross‐over trial comparing articaine and lidocaine buccal and buccal plus lingual infiltrations. British Dental Journal 2010;209(9):E16. [PUBMED: 20953168] - PubMed
Jain 2016 {published data only}
    1. Jain NK, John RR. Anesthetic efficacy of 4% articaine versus 2% lignocaine during the surgical removal of the third molar: a comparative prospective study. Anesthesia Essays and Researches 2016;10(2):356‐61. [DOI: 10.4103/0259-1162.171445] - DOI - PMC - PubMed
Kalia 2011 {published data only}
    1. Kalia V, Supreet KR. Comparative evaluation of onset and duration of anesthesia of 4% articaine versus 2% lidocaine with epinephrine 1:100,000 during exodontia. Indian Journal of Comprehensive Dental Care 2011;1(1):19‐24. [2231‐6973]
Kambalimath 2013 {published data only}
    1. Kambalimath DH, Dolas RS, Kambalimath HV, Agrawal SM. Efficacy of 4% articaine and 2% lidocaine: a clinical study. Journal of Maxillofacial and Oral Surgery 2013;12(1):3‐10. [DOI: 10.1007/s12663-012-0368-4] - DOI - PMC - PubMed
Kammerer 2012 {published data only}
    1. Kammerer PW, Palarie V, Daublander M, Bicer C, Shabazfar N, Brullmann D, et al. Comparison of 4% articaine with epinephrine (1:100,000) and without epinephrine in inferior alveolar block for tooth extraction: double‐blind randomized clinical trial of anesthetic efficacy. Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology 2012;113(4):495‐9. [PUBMED: 22676931] - PubMed
Kammerer 2014 {published data only}
    1. Kammerer PW, Seeling J, Alshihri A, Daublander M. Comparative clinical evaluation of different epinephrine concentrations in 4% articaine for dental local infiltration anesthesia. Clinical Oral Investigations 2014;18(2):415‐21. [MEDLINE: ] - PubMed
Kanaa 2006 {published data only}
    1. Kanaa MD, Whitworth JM, Corbett IP, Meechan JG. Articaine and lidocaine mandibular buccal infiltration anesthesia: a prospective randomized double‐blind cross‐over study. Journal of Endodontics 2006;32(4):296‐8. [PUBMED: 16554198] - PubMed
Kanaa 2012 {published data only}
    1. Kanaa MD, Whitworth JM, Meechan JG. A comparison of the efficacy of 4% articaine with 1:100,000 epinephrine and 2% lidocaine with 1:80,000 epinephrine in achieving pulpal anesthesia in maxillary teeth with irreversible pulpitis. Journal of Endodontics 2012;38(3):279‐82. [PUBMED: 22341059] - PubMed
Karm 2017 {published data only}
    1. Karm MH, Park FD, Kang M, Kim HJ, Kang JW, Kim S, et al. Comparison of the efficacy and safety of 2% lidocaine HCl with different epinephrine concentration for local anesthesia in participants undergoing surgical extraction of impacted mandibular third molars. Medicine 2017;96(21):e6753. [EMBASE: 616768530] - PMC - PubMed
Katz 2010 {published data only}
    1. Katz S, Drum M, Reader A, Nusstein J, Beck M. A prospective, randomized, double‐blind comparison of 2% lidocaine with 1:100,000 epinephrine, 4% prilocaine with 1:200,000 epinephrine, and 4% prilocaine for maxillary infiltrations. Anesthesia Progress 2010;57(2):45‐51. [PUBMED: 20553134] - PMC - PubMed
Keskitalo 1975 {published data only}
    1. Keskitalo E, Persson G. Complications after removal of mandibular third molars with special reference to local anaesthetics with different vasoactive properties. Odontologisk Revy 1975;26(2):149‐64. [PUBMED: 1097978] - PubMed
Khoury 1991 {published data only}
    1. Khoury F, Hinterthan A, Schurmann J, Arns H. Clinical comparative study of local anesthetics. Random double blind study with four commercial preparations. Deutsche Zahnarztliche Zeitschrift 1991;46(12):822‐4. [PUBMED: 1817898] - PubMed
Knoll‐Kohler 1992a {published data only}
    1. Knoll‐Kohler E, Fortsch G. Pulpal anesthesia dependent on epinephrine dose in 2% lidocaine. A randomized controlled double‐blind crossover study. Oral Surgery, Oral Medicine, Oral Pathology 1992;73(5):537‐40. [PUBMED: 1518636] - PubMed
Knoll‐Kohler 1992b {published data only}
    1. Knoll‐Kohler E, Rupprecht S. Articaine for local anaesthesia in dentistry. A lidocaine controlled double blind cross‐over study. European Journal of Pain 1992;13(2):59‐63. [EMBASE: 1992242721]
Kolli 2017 {published data only}
    1. Kolli NK, Nirmala SV, Nuvvula S. The effectiveness of articaine and lidocaine single buccal infiltration versus conventional buccal and palatal injection using lidocaine during primary maxillary molar extraction: a randomized control trial. Anesthesia Essays and Researches 2017;11(1):160‐4. [PUBMED: 28298777] - PMC - PubMed
Kramer 1958 {published data only}
    1. Kramer WS. A comparative clinical evaluation of some commonly used local anesthetic compounds. Journal of the American Dental Association 1958;56(6):820‐30. [PUBMED: 13538629] - PubMed
Lasemi 2015 {published data only}
    1. Lasemi E, Sezavar M, Habibi L, Hemmat S, Sarkarat F, Nematollahi Z. Articaine (4%) with epinephrine (1:100,000 or 1:200,000) in inferior alveolar nerve block: effects on the vital signs and onset, and duration of anesthesia. Journal of Dental Anesthesia and Pain Medicine 2015;15(4):201‐5. [DOI: 10.17245/jdapm.2015.15.4.201] - DOI - PMC - PubMed
Laskin 1977 {published data only}
    1. Laskin JL, Wallace WR, DeLeo B. Use of bupivacaine hydrochloride in oral surgery ‐ a clinical study. Journal of Oral Surgery 1977;35(1):25‐9. [PUBMED: 264254] - PubMed
Lawaty 2010 {published data only}
    1. Lawaty I, Drum M, Reader A, Nusstein J. A prospective, randomized, double‐blind comparison of 2% mepivacaine with 1:20,000 levonordefrin versus 2% lidocaine with 1:100,000 epinephrine for maxillary infiltrations. Anesthesia Progress 2010;57(4):139‐44. [PUBMED: 21174567] - PMC - PubMed
Lima 2009 {published data only}
    1. Lima JL Jr, Dias‐Ribeiro E, Araujo TN, Ferreira‐Rocha J, Honfi ES Jr, Sarmento CFDM, et al. Evaluation of the buccal vestibule‐palatal diffusion of 4% articaine hydrochloride in impacted maxillary third molar extractions. Medicina Oral, Patologia Oral y Cirugia Bucal 2009;14(3):E129‐32. [PUBMED: 19242392] - PubMed
Linden 1986 {published data only}
    1. Linden ET, Abrams H, Matheny J, Kaplan AL, Kopczyk RA, Jasper SJ Jr. A comparison of postoperative pain experience following periodontal surgery using two local anesthetic agents. Journal of Periodontology 1986;57(10):637‐42. [PUBMED: 3534212] - PubMed
Malamed 2000a {published data only}
    1. Malamed SF, Gagnon S, Leblanc D. Efficacy of articaine: a new amide local anesthetic. Journal of the American Dental Association 2000;131(5):635‐42. [PUBMED: 10832257] - PubMed
Malamed 2000b {published data only}
    1. Malamed SF, Gagnon S, Leblanc D. A comparison between articaine HCl and lidocaine HCl in pediatric dental patients. Pediatric Dentistry 2000;22(4):307‐11. [PUBMED: 10969438] - PubMed
Maniglia‐Ferreira 2009 {published data only}
    1. Maniglia‐Ferreira C, Almeida‐Gomes F, Carvalho‐Sousa B, Barbosa AVH, Lins Carla CSA, Souza Fabricio D, et al. Clinical evaluation of the use of three anesthetics in endodontics. Acta Odontologica Latinoamericana 2009;22(1):21‐6. [PUBMED: 19601492] - PubMed
Martinez‐Rodriguez 2012 {published data only}
    1. Martinez‐Rodriguez N, Barona‐Dorado C, Martin‐Ares M, Cortes‐Breton‐Brinkman J, Martinez‐Gonzalez JM. Evaluation of the anaesthetic properties and tolerance of 1:100,000 articaine versus 1:100,000 lidocaine. A comparative study in surgery of the lower third molar. Medicina Oral, Patologia Oral y Cirugia Bucal 2012;17(2):345‐51. [PUBMED: 22143691] - PMC - PubMed
Maruthingal 2015 {published data only}
    1. Maruthingal S, Mohan D, Maroli RK, Alahmari A, Alqahtani A, Alsadoon M. A comparative evaluation of 4% articaine and 2% lidocaine in mandibular buccal infiltration anesthesia: a clinical study. Journal of International Society of Preventive & Community Dentistry 2015;5(6):463–9. [DOI: 10.4103/2231-0762.167717] - DOI - PMC - PubMed
Mason 2009 {published data only}
    1. Mason R, Drum M, Reader A, Nusstein J, Beck M. A prospective, randomized, double‐blind comparison of 2% lidocaine with 1:100,000 and 1:50,000 epinephrine and 3% mepivacaine for maxillary infiltrations. Journal of Endodontics 2009;35(9):1173‐7. [PUBMED: 19720211 ] - PubMed
McEntire 2011 {published data only}
    1. McEntire M, Nusstein J, Drum M, Reader A, Beck M. Anesthetic efficacy of 4% articaine with 1:100,000 epinephrine versus 4% articaine with 1:200,000 epinephrine as a primary buccal infiltration in the mandibular first molar. Journal of Endodontics 2011;37(4):450‐4. [PUBMED: 21419288] - PubMed
McLean 1993 {published data only}
    1. McLean C, Reader A, Beck M, Meryers WJ. An evaluation of 4% prilocaine and 3% mepivacaine compared with 2% lidocaine (1:100,000 epinephrine) for inferior alveolar nerve block. Journal of Endodontics 1993;19(3):146‐50. [PUBMED: 8509754] - PubMed
Mikesell 2005 {published data only}
    1. Mikesell P, Nusstein J, Reader A, Beck M, Weaver. A comparison of articaine and lidocaine for inferior alveolar nerve blocks. Journal of Endodontics 2005;31(4):265‐70. [PUBMED: 15793381] - PubMed
Mittal 2015 {published data only}
    1. Mittal M, Sharma S, Kumar A, Chopra R, Srivastava D. Comparison of anesthetic efficacy of articaine and lidocaine during primary maxillary molar extractions in children. Pediatric Dentistry 2015;37(7):520‐24. - PubMed
Moore 1983 {published data only}
    1. Moore PA, Dunsky JL. Bupivacaine anesthesia ‐ a clinical trial for endodontic therapy. Oral Surgery, Oral Medicine, Oral Pathology 1983;55(2):176‐9. [PUBMED: 6340015] - PubMed
Moore 2006 {published data only}
    1. Moore PA, Boynes SG, Hersh EV, DeRossi SS, Sollecito TP, Goodson JM, et al. The anesthetic efficacy of 4 percent articaine 1:200,000 epinephrine: two controlled clinical trials. Journal of the American Dental Association 2006;137(11):1572‐81. [PUBMED: 17082284] - PubMed
Moore 2007 {published data only}
    1. Moore PA, Doll B, Delie RA, Hersh EV, Korostoff J, Johnson S, et al. Hemostatic and anesthetic efficacy of 4% articaine HCl with 1:200,000 epinephrine and 4% articaine HCl with 1:100,000 epinephrine when administered intraorally for periodontal surgery. Journal of Periodontology 2007;78(2):247‐53. [PUBMED: 17274713] - PubMed
Mumford 1961 {published data only}
    1. Mumford JM, Geddes IC. Trial of carbocaine in conservative dentistry. British Dental Journal 1961;110:92.
Nabeel 2014 {published data only}
    1. Nabeel M, Ahmed A, Sikander M. A comparison of the anesthetic efficacy of lidocaine and articaine for buccal infiltration in patients with acute irreversible pulpitis in maxillary first premolars. Pakistan Oral & Dental Journal 2014;34(4):714‐16. [100212933]
Naik 2017 {published data only}
    1. Naik VG, Rai KK, Adhyaru P. A comparison of efficacy of articaine versus lignocaine in inferior alveolar nerve block during surgical extraction of impacted lower third molar ‐ a randomized single blind prospective study. World Journal of Pharmaceutical and Medical Research 2017;3(1):167‐72. [2455‐3301]
Nespeca 1976 {published data only}
    1. Nespeca JA. Clinical trials with bupivacaine in oral surgery. Oral Surgery, Oral Medicine, Oral Pathology 1976;42(3):301‐7. [PUBMED: 1067530 ] - PubMed
Nordenram 1990 {published data only}
    1. Nordenram A, Danielsson K. Local anaesthesia in elderly patients. An experimental study of oral infiltration anaesthesia. Swedish Dental Journal 1990;14(1):19‐24. [PUBMED: 2363109] - PubMed
Nydegger 2014 {published data only}
    1. Nydegger B, Nusstein J, Reader A, Drum M, Beck M. Anesthetic comparisons of 4% concentrations of articaine, lidocaine, and prilocaine as primary buccal infiltrations of the mandibular first molar: a prospective randomized, double‐blind study. Journal of Endodontics 2014;40(12):1912‐6. [MEDLINE: ] - PubMed
Odabas 2012 {published data only}
    1. Odabas ME, Cinar C, Deveci C, Alacam A. Comparison of the anesthetic efficacy of articaine and mepivacaine in pediatric patients: a randomized, double‐blind study. Pediatric Dentistry 2012;34(1):42‐5. [PUBMED: 22353456] - PubMed
Oliveira 2004 {published data only}
    1. Oliveira PC, Volpato MC, Ramacciato JC, Ranali J. Articaine and lignocaine efficiency in infiltration anaesthesia: a pilot study. British Dental Journal 2004;197(1):45‐6; discussion 33. [PUBMED: 15243610 ] - PubMed
Ozec 2010 {published data only}
    1. Ozec I, Tasdemir U, Gumus C, Solak O. Is it possible to anesthetize palatal tissues with buccal 4% articaine injection?. Journal of Oral and Maxillofacial Surgery 2010;68(5):1032‐7. [PUBMED: 20223573] - PubMed
Parirokh 2015 {published data only}
    1. Parirokh M, Yosefi MH, Nakhaee N, Abbott PV, Manochehrifar H. The success rate of bupivacaine and lidocaine as anesthetic agents in inferior alveolar nerve block in teeth with irreversible pulpitis without spontaneous pain. Restorative Dentistry & Endodontics 2015;40(2):155‐60. [PUBMED: 25984478] - PMC - PubMed
Pässler 1996 {published data only}
    1. Pässler L, Wickede J. Articain, lidocain, prilocain und vasokonstriktorische zusätze‐untersuchungen zur verminderung des anästhesierisikos. Quintessenz 1996;47:669‐78.
Pellicer‐Chover 2013 {published data only}
    1. Pellicer‐Chover H, Cervera‐Ballester J, Sanchis‐Bielsa JM, Peñarrocha‐Diago MA, Peñarrocha‐Diago M, García‐Mira B. Comparative split‐mouth study of the anesthetic efficacy of 4% articaine versus 0.5% bupivacaine in impacted mandibular third molar extraction. Journal of Clinical and Experimental Dentistry 2013;5(2):e66‐71. [PUBMED: 24455059] - PMC - PubMed
Poorni 2011 {published data only}
    1. Poorni S, Veniashok B, Senthilkumar AD, Indira R, Ramachandran S. Anesthetic efficacy of four percent articaine for pulpal anesthesia by using inferior alveolar nerve block and buccal infiltration techniques in patients with irreversible pulpitis: a prospective randomized double‐blind clinical trial. Journal of Endodontics 2011;37(12):1603‐7. [PUBMED: 22099890] - PubMed
Porto 2007 {published data only}
    1. Porto GG, Vasconcelos BC, Gomes AC, Albert D. Evaluation of lidocaine and mepivacaine for inferior third molar surgery. Medicina Oral, Patologia Oral y Cirugia Bucal 2007;12(1):E60‐4. [PUBMED: 17195831] - PubMed
Ram 2006 {published data only}
    1. Ram D, Amir E. Comparison of articaine 4% and lidocaine 2% in paediatric dental patients. International Journal of Paediatric Dentistry 2006;16(4):252‐6. [PUBMED: 16759322] - PubMed
Robertson 2007 {published data only}
    1. Robertson D, Nusstein J, Reader A, Beck M, McCartney M. The anesthetic efficacy of articaine in buccal infiltration of mandibular posterior teeth.. Journal of the American Dental Association 2007;138(8):1104‐12. [PUBMED: 17670879] - PubMed
Ruprecht 1991 {published data only}
    1. Ruprecht S, Knoll‐Kohler E. A comparative study of equimolar solutions of lidocaine and articaine for anesthesia. A randomized double‐blind cross‐over study. Schweizer Monatsschrift fur Zahnmedizin 1991;101(10):1286‐90. [PUBMED: 1947972] - PubMed
Sadove 1962 {published data only}
    1. Sadove MS, Vernino D, Lock F, Kolodny S. An evaluation of mepivacaine hydrochloride. Journal of oral surgery, anesthesia, and hospital dental service 1962;20(5):399‐404. - PubMed
Sampaio 2012 {published data only}
    1. Sampaio RM, Carnaval TG, Lanfredi CB, Ratto Tempestini Horliana AC, Rocha RG, Tortamano IP. Comparison of the anesthetic efficacy between bupivacaine and lidocaine in patients with irreversible pulpitis of mandibular molar. Journal of Endodontics 2012;38(5):594‐7. [PUBMED: 22515885] - PubMed
Sancho‐Puchades 2012 {published data only}
    1. Sancho‐Puchades M, Vilchez‐Perez MA, Valmaseda‐Castellon E, Paredes‐Garcia J, Berini‐Aytes L, Gay‐Escoda C. Bupivacaine 0.5 % versus articaine 4 % for the removal of lower third molars. A crossover randomized controlled trial. Medicina Oral, Patologia Oral y Cirugia Bucal 2012;17(3):e462‐8. [PUBMED: 22143739] - PMC - PubMed
Santos 2007 {published data only}
    1. Santos CF, Modena KC, Giglio FP, Sakai VT, Calvo AM, Colombini BL, et al. Epinephrine concentration (1:100,000 or 1:200,000) does not affect the clinical efficacy of 4% articaine for lower third molar removal: a double‐blind, randomized, crossover study. Journal of Oral & Maxillofacial Surgery 2007;65(12):2445‐52. [PUBMED: 18022467] - PubMed
Sherman 1954 {published data only}
    1. Sherman H, Fiasconaro JE, Chilton NW. A comparison of the clinical effectiveness of the higher potency local anesthetics in operative dentistry. Journal of the American Dental Association 1954;48(2):151‐7. [PUBMED: 13128982] - PubMed
Sherman 2008 {published data only}
    1. Sherman MG, Flax M, Namerow K, Murray PE. Anesthetic efficacy of the Gow‐Gates injection and maxillary infiltration with articaine and lidocaine for irreversible pulpitis. Journal of Endodontics 2008;34(6):656‐9. [PUBMED: 18498883] - PubMed
Sierra Rebolledo 2007 {published data only}
    1. Sierra Rebolledo A, Delgado Molina E, Berini Aytis L, Gay Escoda C. Comparative study of the anesthetic efficacy of 4% articaine versus 2% lidocaine in inferior alveolar nerve block during surgical extraction of impacted lower third molars. Medicina Oral, Patologia Oral y Cirugia Bucal 2007;12(2):E139‐44. [PUBMED: 17322803] - PubMed
Silva 2012 {published data only}
    1. Silva LCF, Santos TS, Santos JASS, Maia MC, Mendonca CG. Articaine versus lidocaine for third molar surgery: A randomized clinical study. Medicina Oral, Patologia Oral y Cirugia Bucal 2012;17(1):e140‐5. [PUBMED: 22157664] - PMC - PubMed
Sood 2014 {published data only}
    1. Sood R, Manoj‐Kumar H, Shetty S. Comparison of anesthetic efficacy of 4% articaine with 1:100,000 epinephrine and 2% lidocaine with 1:80,000 epinephrine for inferior alveolar nerve block in patients with irreversible pulpitis. Journal of Clinical and Experimental Dentistry 2014;6(5):e520‐3. - PMC - PubMed
Srinivasan 2009 {published data only}
    1. Srinivasan N, Kavitha M, Loganathan CS, Padmini G. Comparison of anesthetic efficacy of 4% articaine and 2% lidocaine for maxillary buccal infiltration in patients with irreversible pulpitis. Oral Surgery Oral Medicine Oral Pathology Oral Radiology & Endodontics 2009;107(1):133‐6. [PUBMED: 19101495] - PubMed
Srisurang 2011 {published data only}
    1. Srisurang S, Narit L, Prisana P. Clinical efficacy of lidocaine, mepivacaine, and articaine for local infiltration. Journal of Investigative and Clinical Dentistry 2011;2(1):23‐8. [EMBASE: 25427324] - PubMed
Stibbs 1964 {published data only}
    1. Stibbs GD, Korn JH. An evaluation of the local anaesthetic mepivacaine hydrochloride, in operative dentistry. Journal of Prosthetic Dentistry 1964;14(2):355‐64.
Thakare 2014 {published data only}
    1. Thakare A, Bhate K, Kathariya R. Comparison of 4% articaine and 0.5% bupivacaine anesthetic efficacy in orthodontic extractions: prospective, randomized crossover study. Acta Anaesthesiologica Taiwanica 2014;52(2):59‐63. [EMBASE: 2014469720] - PubMed
Tofoli 2003 {published data only}
    1. Tofoli GR, Ramacciato JC, Oliveira PC, Volpato MC, Groppo FC, Ranali J. Comparison of effectiveness of 4% articaine associated with 1: 100,000 or 1: 200,000 epinephrine in inferior alveolar nerve block. Anesthesia Progress 2003;50(4):164‐8. [PUBMED: 14959904] - PMC - PubMed
Tortamano 2009 {published data only}
    1. Tortamano IP, Siviero M, Costa CG, Buscariolo IA, Armonia PL. A comparison of the anesthetic efficacy of articaine and lidocaine in patients with irreversible pulpitis. Journal of Endodontics 2009;35(2):165‐8. [PUBMED: 19166765] - PubMed
Tortamano 2013 {published data only}
    1. Tortamano IP, Siviero M, Lee S, Sampaio RM, Simone JL, Rocha RG. Onset and duration period of pulpal anesthesia of articaine and lidocaine in inferior alveolar nerve block. Brazilian Dental Journal 2013;24(4):371‐4. [EMBASE: 24173259] - PubMed
Trieger 1979 {published data only}
    1. Trieger N, Gillen GH. Bupivacaine anesthesia and post‐operative analgesia in oral surgery. Anesthesia Progress 1979;26(1):20‐3. [PUBMED: 295581] - PMC - PubMed
Trullenque‐Eriksson 2011 {published data only}
    1. Trullenque‐Eriksson A, Guisado‐Moya B. Comparative study of two local anesthetics in the surgical extraction of mandibular third molars: bupivacaine and articaine. Medicina Oral, Patologia Oral y Cirugia Bucal 2011;16(3):e390‐6. [PUBMED: 21196829] - PubMed
Vahatalo 1993 {published data only}
    1. Vahatalo K, Antila H, Lehtinen R. Articaine and lidocaine for maxillary infiltration anesthesia. Anesthesia Progress 1993;40(4):114‐6. [PUBMED: 7943919] - PMC - PubMed
Vilchez‐Perez 2012 {published data only}
    1. Vilchez‐Perez MA, Sancho‐Puchades M, Valmaseda‐Castellon E, Paredes‐Garcia J, Berini‐Aytes L, Gay‐Escoda C. A prospective, randomized, triple‐blind comparison of articaine and bupivacaine for maxillary infiltrations. Medicina Oral, Patologia Oral y Cirugia Bucal 2012;17(2):325‐30. [PUBMED: 22143708] - PMC - PubMed
Visconti 2016 {published data only}
    1. Visconti RP, Tortamano IP, Buscariolo IA. Comparison of the anesthetic efficacy of mepivacaine and lidocaine in patients with irreversible pulpitis: a double‐blind randomized clinical trial. Journal of Endodontics 2016;42(9):1314‐19. [PUBMED: 27475099 ] - PubMed
Vreeland 1989 {published data only}
    1. Vreeland DL, Reader A, Beck M, Meyers W, Weaver J. An evaluation of volumes and concentrations of lidocaine in human inferior alveolar nerve block. Journal of Endodontics 1989;15(1):6‐12. [PUBMED: 2607268] - PubMed
Wali 2010 {published data only}
    1. Wali M, Drum M, Reader A, Nusstein J. Prospective, randomized single‐blind study of the anesthetic efficacy of 1.8 and 3.6 milliliters of 2% lidocaine with 1:50,000 epinephrine for inferior alveolar nerve block. Journal of Endodontics 2010;36(9):1459‐62. [PUBMED: 20728709] - PubMed
Weil 1961 {published data only}
    1. Weil C, Santangelo C, Welham FS, Yackel RF. Clinical evaluation of mepivacaine hydrochloride by a new method. Journal of the American Dental Association 1961;63:26‐32. [PUBMED: 13783827] - PubMed
Yadav 2015 {published data only}
    1. Yadav M, Grewal MS, Grewal S, Deshwal P. Comparison of preoperative oral ketorolac on anesthetic efficacy of inferior alveolar nerve block and buccal and lingual infiltration with articaine and lidocaine in patients with irreversible pulpitis: a prospective, randomized, controlled, double‐blind study. Journal of Endodontics 2015;41(11):1773‐7. [EMBASE: 616595072] - PubMed
Yared 1997 {published data only}
    1. Yared GM, Dagher FB. Evaluation of lidocaine in human inferior alveolar nerve block. Journal of Endodontics 1997;23(9):575‐8. [PUBMED: 9587285] - PubMed
Yilmaz 2011 {published data only}
    1. Yilmaz Y, Eyuboglu O, Keles S. Comparison of the efficacy of articaine and prilocaine local anaesthesia for pulpotomy of maxillary and mandibular primary molars. European Journal of Paediatric Dentistry 2011;12(2):117‐22. [PUBMED: 21668284] - PubMed
Yonchak 2001 {published data only}
    1. Yonchak T, Reader A, Beck M, Clark K, Meyers WJ. Anesthetic efficacy of infiltrations in mandibular anterior teeth. Anesthesia Progress 2001;48(2):55‐60. [PUBMED: 11515948] - PMC - PubMed

References to studies excluded from this review

Adler 1969 {published data only}
    1. Adler R, Aler G, Aberg G. Effects of optically active isomers and racemate of mepivacaine (Carbocaine) in dental anaesthesia. Svensk Tandlakaretidskrift 1969;62(8):501‐4. [PUBMED: 4911578] - PubMed
Caruso 1989 {published data only}
    1. Caruso JM, Brokaw WC, Blanton EE. Bupivacaine and lidocaine compared for postoperative pain control. General Dentistry 1989;37(2):148‐51. [PUBMED: 2599329] - PubMed
Cowan 1964 {published data only}
    1. Cowan A. Minimum dosage technique in the clinical comparison of representative modern local anesthetic agents. Journal of Dental Research 1964;43:1228‐49. [PUBMED: 14238893] - PubMed
Cowan 1968 {published data only}
    1. Cowan A. Further clinical evaluation of prilocaine (Citanest), with and without epinephrine. Oral Surgery, Oral Medicine, Oral Pathology 1968;26(3):304‐11. [PUBMED: 4875791] - PubMed
Hassan 2011 {published data only}
    1. Hassan S, Sripathi Rao BH, Sequeria J, Rai G. Efficacy of 4% articaine hydrochloride and 2% lignocaine in the extraction of maxillary premolars for orthodontic reasons. Annals of Maxillofacial Surgery 2011;1(1):14‐8. - PMC - PubMed
Kanaa 2009 {published data only}
    1. Kanaa MD, Whitworth JM, Corbett IP, Meechan JG. Articaine buccal infiltration enhances the effectiveness of lidocaine inferior alveolar nerve block. International Endodontic Journal 2009;42(3):238‐46. [PUBMED: 19228214] - PubMed
Raab 1990 {published data only}
    1. Raab WH, Muller R, Muller HF. Comparative investigations of anesthetic activity of 2‐ and 4% articain. Quintessenz 1990;41(7):1207‐16. - PubMed
Shruthi 2013 {published data only}
    1. Shruthi R, Kedarnath N, Mamatha N, Rajaram P, BhadraShetty D. Articaine for surgical removal of impacted third molar; a comparison with lignocaine. Journal of International Oral Health 2013;5(1):48‐53. [PUBMED: 24155578 ] - PMC - PubMed

References to studies awaiting assessment

Chen 2004 {published data only}
    1. Chen XM, Shi ZD, Huang DM, Zeng HB, Wang XY, Ding Y. Anesthetic efficacy of 2% mepivacaine in conservative dentistry. West China Journal of Stomatology 2004;22(5):390‐2. - PubMed
da Silva‐Junior 2017 {published data only}
    1. Silva‐Junior GP, Almeida Souza LM, Groppo FC. Comparison of articaine and lidocaine for buccal infiltration after inferior alveolar nerve block for intraoperative pain control during impacted mandibular third molar surgery. Anesthesia Progress 2017;64(2):80‐4. [PUBMED: 28604089] - PMC - PubMed
Dong 2010 {published data only}
    1. Dong HD, Liu Q. The pulpal anesthetic efficacy of the scandonest on maxillary pulpitis molars. Journal of Practical Stomatology 2010;26:609‐11.
Ge 2005 {published data only}
    1. Ge XJ, Li X, Wang XY. Comparison between scandonest and lidocaine in the endodontic treatment of the mandibular posterior teeth. Chinese Remedies and Clinics 2005;15:956‐7.
Guo 2014 {published data only}
    1. Guo SL, Yang WD, Jiang WM. Comparison of anesthetic efficacy of 2% lidocaine and 4% articaine in patients with irreversible pulpitis in maxillary teeth. Jilin Medical Journal 2014;35:1795‐7.
He 2010 {published data only}
    1. He P, Wang JR. Application of scandonest in endodontic treatment. Stomatology 2010;30:511‐2.
Huang 2011 {published data only}
    1. Huang YD, Xia H, Li XD, Yang XZ, Pei ZQ, Xia X. A comparison of the clinical anesthetic efficacy of articaine infiltration and lidocaine blocking for microport extraction of impacted mandibular molar. West China Journal of Stomatology 2011;29(3):268‐71. [MEDLINE: ] - PubMed
Im 2010 {published data only}
    1. Im TY, Hwang KG, Park CJ, Kim KS, Oh Y, Han JY, et al. Randomized, double‐blind, comparative clinical trial on the efficacy of 4% articaine and 2% lidocaine in inferior alveolar nerve block anesthesia. Journal of the Korean Dental Society of Anesthesiology 2010;10(1):1‐6. [DOI: 10.17245/jkdsa.2010.10.1.1] - DOI
Jin 2005 {published data only}
    1. Jin XD, Wang GL. Efficacy of mepivacaine hydrochloride with epinephrine in endodontic treatment. Guangdong Medical Journal 2005;26:694‐5.
Lee 2004 {published data only}
    1. Lee WY, Park CJ, Seo KS, Kim HJ, Yum KW. Comparative study for the anesthetic efficacy between articaine HCl and lidocaine HCl during the surgical extraction of bilateral mandibular impacted third molars. Journal of the Korean Dental Society of Anesthesiology 2004;4(1):13‐6. [DOI: 10.17245/jkdsa.2004.4.1.13] - DOI
Li 2005 {published data only}
    1. Li SY, Liu Y, Liu RS. Clinical evaluation of the anesthetic effect of mepivacaine hydrochloride and adrenaline injection during pulpal treatment in the elderly. Chinese Journal of Geriatric Dentistry 2005;3:78‐80.
Liang 2001 {published data only}
    1. Liang ZD, Hu YL, Guan SN, Li L, He KX. Observation of anesthetic efficacy of articaine in endodontic treatment. Journal of Guangxi Medical University 2001;18:529‐30.
Liao 2004 {published data only}
    1. Liao MH. Observation of anesthetic efficacy of articaine in pulp inactivation. Journal of Youjiang Medical College for Nationalities 2004;4:504‐5.
Liu 2010 {published data only}
    1. Liu MZ. Application of mepivacaine hydrochloride injection in tooth extraction and endodontic treatment. Chinese Journal of Nursing Education 2010;7:378‐9.
Luo 2009 {published data only}
    1. Luo LC, Li H. Comparison of anesthetic effect between scandonest and lidocaine in the extraction of the upper molar. Hainan Medical Journal 2009;20:204‐5.
Manabe 2005 {published data only}
    1. Manabe Y, Seto M, Koyanagi N, Tominaga S, Taniguchi S. An evaluation of 3% mepivacaine compared with 2% lidocaine (1:80,000 epinephrine) for the inferior alveolar nerve block. [Japanese]. Journal of Japanese Dental Society of Anesthesiology 2005;33(3):369‐72. [EMBASE: 2005356341]
Oka 1990 {published data only}
    1. Oka S. Effect of the concentration of the vasoconstrictor in local anesthetic on local anesthesia and hemodynamics. Journal of Japanese Dental Society of Anesthesiology 1990;1:43‐66.
Ouchi 2008 {published data only}
    1. Ouchi K, Sunada K. Randomized controlled study of felypressin‐propitocaine and mepivacaine for inferior alveolar nerve block. [Japanese]. Journal of Japanese Dental Society of Anesthesiology 2008;36(3):263‐8. [EMBASE: 2008395088]
Qiu 2007 {published data only}
    1. Qiu YY, Zhou TQ. Comparison of efficacy between two kinds of anesthesia in pulpectomy. Modern Hospital 2007;7:30‐1.
Qiu 2011 {published data only}
    1. Qiu H, Wang RY. Anesthetic efficacy of articaine for premolars in the mandibular in endodontic treatment. Hebei Medical Journal 2011;33:2494.
Shi 2002 {published data only}
    1. Shi ZD, Wang XY, Chen ZY, Yang XM, Chen XM, Xu BH, et al. Multi‐center randomized double‐blinded controlled clinical trial on local anesthetic efficacy of scandonest 2% special and its safety. Chinese Journal of Evidence‐Based Medicine 2002;2:86‐91.
Shimada 2002 {published data only}
    1. Shimada M, Miyawaki T, Takada K, Misaki T, Oka S, Yoshimura S, et al. The clinical anesthetic efficacy of 3% mepivacaine in infiltration and block anesthesia: a comparative double blind study with 2% lidocaine hydrochloride containing 1:80,000 epinephrine. [Japanese]. Journal of Japanese Dental Society of Anesthesiology 2002;30(1):48‐61. [EMBASE: 2002060162]
Wang 2009 {published data only}
    1. Wang LC, Zheng J, Zhang FY. Analysis of efficacy of articaine in irreversible pulpitis. Journal of Modern Medicine and Health 2009;25:850.
Wu 2005 {published data only}
    1. Wu YN, Yang SQ, Zhu QP, Wang JH, Guo W, Fu CF. Effects of three local anesthesia agents during procedures of pulpectomy. Stomatology 2005;25:291‐2.
Xie 2008 {published data only}
    1. Xie GY. Observation of the local anesthesia effect for aged acute pulpitis. Journal of Practical Medical Techniques 2008;15:3171‐2.
Xing 2005 {published data only}
    1. Xing XY, Xing WB, Zhang QS. Clinical evaluation of the effect of scandonest (mepivacaine hydrochloride) used in dentistry. Journal of Tianjin Medical University 2005;11:243‐5.
Xu 1991 {published data only}
    1. Xu SS, Qian CH. Clinical research of bupivacaine in endodontic treatment. Journal of Comprehensive Stomatology 1991;7:113‐4.
Xu 2008 {published data only}
    1. Xu X, Ji HH, Yang Y, Cao XM, Gao YG. Application and therapeutic effect of articaine in the dental treatment. Chinese Journal of Modern Drug Application 2008;2:11‐2.
Xu 2013 {published data only}
    1. Xu XY. Anesthetic efficacy of local infiltration anesthesia with primacaine adrenaline and inferior alveolar nerve block anesthesia with lidocaine hydrochloride in patients with acute pulpitis in mandibular. National Medical Frontiers of China 2013;8:87‐8.
Xuan 2007 {published data only}
    1. Xuan GJ. Application of scandonest in teeth preparation of vital pulp. Journal of Clinical Stomatology 2007;123:190‐1.
Zhang 2005 {published data only}
    1. Zhang L, Lin XF, Chen G, Li Y. Clinical observation of local anesthesia in dentistry for articaine. Chinese Journal of School Doctor 2005;19:308‐9.
Zhang 2009 {published data only}
    1. Zhang DH. Observation of clinical efficacy of articaine in endodontic treatment. Medical Journal of Chinese People's Health 2009;21:2378‐9.
Zhou 2011 {published data only}
    1. Zhou Q. Observation of mepivacaine hydrochloride with epinephrine solutions in inferior alveolar nerve block anesthesia. Modern Practical Medicine 2011;23:1257‐9.
Zhou 2013 {published data only}
    1. Zhou Y, You GL, Qiu SB, et al. Comparison of anesthetic effects of articaine and lidocaine in acute attack of chronic pulpitis odontotrypy. Chinese Pharmacy 2013;24:4543‐4.

References to ongoing studies

Caicedo 1996 {published data only}
    1. Caicedo R, Helo JF, Lopez J. Evaluation of three anesthetic solutions using two local anesthesia techniques. Journal of Endodontics 1996;22(4):209.
Iqbal 2009 {published data only}
    1. Iqbal MK, Greenberg BD, Wang D, Hersh EV, Pinto A. Comparison of anesthetic efficacy of articaine and lidocaine for inferior alveolar nerve blocks with buccal infiltrations in patients with irreversible pulpitis. Journal of Endodontics 2009;35(3):448.
Sheikh 2014 {published data only}
    1. Sheikh S. Preliminary comparison of missed blocks with 4% articaine and 2% lidocaine both with 1:100,000 epinephrine on inferior alveolar nerve block injections. American Association of Oral and Maxillofacial Surgeons (AAOMS) Conference 2014 September 8‐13. 2014:e51‐2.

Additional references

Begg 1994
    1. Begg CB, Mazumdar M. Operating characteristics of a rank correlation test for publication bias. Biometrics 1994;50:1088‐101. [PUBMED: 7786990] - PubMed
Brandt 2011
    1. Brandt RG, Anderson PF, McDonald NJ, Sohn W, Peters MC. The pulpal anesthetic efficacy of articaine versus lidocaine in dentistry a meta‐analysis. Journal of the American Dental Association 2011;142(5):493‐504. - PubMed
Certosimo 1996
    1. Certosimo AJ, Archer RD. A clinical evaluation of the electric pulp tester as an indicator of local anesthesia. Operative Dentistry 1996;21(1):25‐30. - PubMed
Clark 1999
    1. Clark S, Reader A, Beck M, Meyers WJ. Anesthetic efficacy of the mylohyoid nerve block and combination inferior alveolar nerve/mylohyoid nerve block. Oral Surgery, Oral Medicine, Oral Pathology 1999;87:557‐63. [PUBMED: 10348512] - PubMed
Corbella 2017
    1. Corbella S, Taschieri S, Mannocci F, Rosen E, Tsesis I, Fabbro M. Inferior alveolar nerve block for the treatment of teeth presenting with irreversible pulpitis: a systematic review of the literature and meta‐analysis. Quintessence International 2017;48(1):69‐82. [121334449] - PubMed
Dreven 1987
    1. Dreven LJ, Reader A, Beck M, Meyers WJ, Weaver J. An evaluation of an electric pulp tester as a measure of analgesia in human vital teeth. Journal of Endodontics 1987;13(5):233‐8. - PubMed
Egger 1997
    1. Egger M, Davey Smith G, Schneider M, Minder C. Bias in meta‐analysis detected by a simple, graphical test. BMJ 1997;315:629‐34. [PUBMED: 9310563] - PMC - PubMed
Elbourne 2002
    1. Elbourne DR, Altman DG, Higgins JP, Worthington HV, Vail A. Meta‐analysis involving cross‐over trials: methodological issues. International Journal of Epidemiology 2002;31:140‐9. [PUBMED: 11914310] - PubMed
Garisto 2010
    1. Garisto GA, Gaffen AS, Lawrence HP, Tenenbaum HC, Haas DA, Garisto Gabriella A, et al. Occurrence of paresthesia after dental local anesthetic administration in the United States.[Erratum appears in J Am Dent Assoc. 2010 Aug;141(8):944]. Journal of the American Dental Association 2010;141(7):836‐44. - PubMed
Gow‐Gates 1973
    1. Gow‐Gates GA. Mandibular conduction anesthesia: a new technique using extraoral landmarks. Oral Surgery, Oral Medicine, Oral Pathology 1973;36(3):321‐8. [PUBMED: 4516460] - PubMed
GRADEpro GDT [Computer program]
    1. McMaster University (developed by Evidence Prime). GRADEpro GDT. Version accessed 6 August 2016. Hamilton (ON): McMaster University (developed by Evidence Prime), 2015.
Gray 1987
    1. Gray RJ, Lomax AM, Rood JP. Periodontal ligament injection: with or without a vasoconstrictor?. British Dental Journal 1987;162:263‐5. [PUBMED: 3472559] - PubMed
Haas 1995
    1. Haas DA, Lennon D. A 21 year retrospective study of reports of paraesthesia following local anaesthetic administration. Journal (Canadian Dental Association) 1995;61:319‐30. [PUBMED: 7736335] - PubMed
Hargreaves 2001
    1. Hargreaves KM. Neurochemical factors in injury and inflammation in orofacial tissues. In: Lavigne GJ, Lund JP, Sessle BJ, Dubner R editor(s). Orofacial Pain: Basic Sciences to Clinical Management. Chicago: Quintessence, 2001.
Heft 1984
    1. Heft MW, Parker SR. An experimental basis for revising the graphic rating scale for pain. Pain 1984;19(2):153‐61. [PUBMED: 6462727] - PubMed
Hicks 2001
    1. Hicks C, Baeyer C, Spafford P, Korlaar I, Goodenough B. The faces pain scale–revised: toward a common metric in pediatric pain measurement. Pain 2001;93:173–83. [PUBMED: 11427329] - PubMed
Higgins 2011a
    1. Higgins JP, Green S, editor(s). Cochrane Handbook for Systematic Reviews of Interventions Version 5.1.0 (updated March 2011). The Cochrane Collaboration, 2011. Available from handbook.cochrane.org.
Higgins 2011b
    1. Higgins JP, Deeks JJ, Altman DG. Chapter 16: Special topics in statistics. In: Higgins JP, Green S, editor(s). Cochrane Handbook for Systematic Reviews of Interventions Version 5.1.0 (updated March 2011). The Cochrane Collaboration, 2011. Available from handbook.cochrane.org.
Hillerup 2006
    1. Hillerup S, Jensen R. Nerve injury caused by mandibular block analgesia. International Journal of Oral and Maxillofacial Surgery 2006;35:437‐43. [PUBMED: 16343853] - PubMed
Katyal 2010
    1. Katyal V, Katyal Vandana. The efficacy and safety of articaine versus lignocaine in dental treatments: a meta‐analysis. Journal of Dentistry 2010;38(4):307‐17. - PubMed
Kaufman 1984
    1. Kaufman E, Weinstein P, Milgrom P. Difficulties in achieving local anesthesia. Journal of the American Dental Association 1984;108:205‐8. [PUBMED: 6584494] - PubMed
Kung 2015
    1. Kung J, McDonagh M, Sedgley C. Does articaine provide an advantage over lidocaine in patients with symptomatic irreversible pulpitis? A systematic review and meta‐analysis. Journal of Endodontics 2015;41(11):1784‐94. - PubMed
Malamed 1982
    1. Malamed SF. The periodontal ligament (pdl) injection: an alternative to inferior alveolar nerve block. Oral Surgery, Oral Medicine, Oral Pathology 1982;53:117‐21. [PUBMED: 6949113] - PubMed
Meechan 1997
    1. Meechan JG. Plasma potassium changes in hypertensive patients undergoing oral surgery with local anesthetics containing epinephrine. Anesthesia Progress 1997;44:106‐9. [PUBMED: 9481971] - PMC - PubMed
Meechan 2001
    1. Meechan JG, Cole B, Welbury RR. The influence of two different dental local anaesthetic solutions on the haemodynamic responses of children undergoing restorative dentistry: a randomised, single‐blind, split‐mouth study. British Dental Journal 2001;190:502‐4. [PUBMED: 11384023] - PubMed
Meechan 2002
    1. Meechan JG, Ledvinka JIM. Pulpal anaesthesia for mandibular central incisor teeth: a comparison of infiltration and intraligamentary injections. International Endodontic Journal 2002;35:629‐34. [PUBMED: 12190903] - PubMed
Meechan 2010
    1. Meechan JG. Infiltration anesthesia in the mandible. Dental Clinics of North America 2010;54(4):621‐9. - PubMed
Microsoft Excel [Computer program]
    1. Microsoft. Microsoft Office Excel 2007. Redmond, Washington: Microsoft, 2007.
Paxton 2010
    1. Paxton K, Thome DE. Efficacy of articaine formulations: quantitative reviews. Dental Clinics of North America 2010;54(4):643‐53. - PubMed
RevMan 2014 [Computer program]
    1. The Nordic Cochrane Centre, The Cochrane Collaboration. Review Manager 5 (RevMan 5). Version 5.3. Copenhagen: The Nordic Cochrane Centre, The Cochrane Collaboration, 2014.
Rood 1972
    1. Rood JP. Ocular complication of inferior dental nerve block. British Dental Journal 1972;132:23‐4. [PUBMED: 4501854] - PubMed
Rood 1976
    1. Rood JP. Inferior alveolar nerve blocks. The use of 5% lignocaine. British Dental Journal 1976;140:413‐4. [PUBMED: 1067102] - PubMed
Rood 1977
    1. Rood JP. The nerve supply of the mandibular incisor region. British Dental Journal 1977;143:227‐30.
STATA 13 [Computer program]
    1. StataCorp. Stata Statistical Software: Release 13. Version 13. College Station, TX, USA: StataCorp, 2013.
STATA 7 [Computer program]
    1. StataCorp. Stata Statistical Software: Release 7. Version 7. College Station, TX, USA: StataCorp, 2000.
Su 2014a
    1. Su N, Wang H, Zhang S, Liao S, Yang S, Huang Y. Efficacy and safety of bupivacaine versus lidocaine in dental treatments: a meta‐analysis of randomised controlled trials. International Dental Journal 2014;64(1):34‐45. - PMC - PubMed
Su 2014b
    1. Su N, Liu Y, Yang X, Shi Z, Huang Y. Efficacy and safety of mepivacaine compared with lidocaine in local anaesthesia in dentistry: a meta‐analysis of randomised controlled trials. International Dental Journal 2014;64(2):96‐107. - PMC - PubMed
Su 2016
    1. Su NC, Li CJ, Wang H, Shen JF, Liu WJ, Kou L. Efficacy and safety of articaine versus lidocaine for irreversible pulpitis treatment: a systematic review and meta‐analysis of randomised controlled trials. Australian Endodontic Journal 2016;42(1):4‐15. - PubMed
Taddio 1994
    1. Taddio A, Nulman I, Goldbach M, Ipp M, Koren G. Use of lidocaine‐prilocaine cream for vaccination pain in infants. Journal of Pediatrics 1994;124(4):643‐8. - PubMed
White 1998
    1. White JJ, Reader A. Beck M, Meyers WJ. The periodontal ligament injection: a comparison of the efficacy in human maxillary and mandibular teeth. Journal of Endodontics 1998;14:508‐14. [PUBMED: 3255778] - PubMed
Wong 1988
    1. Wong DL, Baker CM. Pain in children: comparison of assessment scales. Pediatric Nursing 1988;14(1):9‐17. - PubMed
Xiao 2010
    1. Xiao JL, Li YL, Ma B, Peng H, Shi QL, Yu ZH. Anesthetic efficacy of articaine versus lidocaine for irreversible pulpitis: a meta‐analysis. [Chinese]. Chinese Journal of Evidence‐Based Medicine 2010;10(9):1058‐62. [EMBASE: 2010601600]

References to other published versions of this review

St George 2007
    1. George G, Morgan A, Meechan J, Moles DR, Needleman I, Ng. Injectable local anaesthetic agents for operative dental anaesthesia. Cochrane Database of Systematic Reviews 2007, Issue 2. [DOI: 10.1002/14651858.CD006487] - DOI - PMC - PubMed

Publication types

MeSH terms

Substances