Methods: A total of 244 patients (38.1% males and 61.9% females) who arrived at an endodontic dental clinic participated in the study. Patients were randomally assigned to receive one cartridge of 4% articaine with 1:100,000 epinephrine or 2% lidocaine with 1:100,000 epinephrine for local anesthesia prior to the performance of root canal treatment. The efficacy of the anesthesia was evaluated by the need for additional injection and by self perceived information on pain. Self perceived pain was reported by the patient with regards to few time points on a Visual Analogue Scale (VAS) from 0 to 10 (total pain perception, pain during injection, pain during treatment). Heart rate was electronically measured before treatment, during injection and during treatment.
Results: Overall, 244 patients (38.1% males and 61.9% females) were evaluated; 128 (52.5%) treated with lidocaine and 116 (47.5%) with articaine. Teeth distribution was 12.7% incisors, 28.7% premolars and 58.6% molars. There was no statistically difference in the requirement for additional injection. Patients in the articaine group graded their pain to be lower on VAS scale at all time points (p<0.005). A statistically significant difference in heart rate following lidocaine injection compared to following articaine injection was observed (84.63 vs. 81.63 beats per minute respectively; p=0.048).
Conclusions: Local infiltration of 4% articaine with 1:100,000 epinephrine statistically resulted less self reported pain when compared with 2% lidocaine with 1:100,000 epinephrine during endodontic treatment.