UNASSIGNED: To investigate the comparative effects of local anesthesia using lidocaine with adrenaline vs. articaine with adrenaline in endoscopic endonasal dacryocystorhinostomy (EN-DCR).
UNASSIGNED: This retrospective study included a total of 180 patients. These patients were categorized into two groups: the lidocaine group, which received 2% lidocaine (1:100,000 adrenaline), and the articaine group, which received 4% articaine (1:100,000 adrenaline) for local anesthesia. The study compared anesthesia efficacy, intraoperative pain levels, intraoperative bleeding, as well as differences in heart rate and blood pressure between the two groups.
UNASSIGNED: The articaine group demonstrated a significantly lower visual analog scale (VAS) pain score when compared to the lidocaine group, measuring at 4.4 ± 0.6 cm vs. 5.0 ± 1.0 cm, respectively (P < 0.0001). Additionally, the articaine group exhibited a higher anesthesia efficacy compared to the lidocaine group (89.0% vs. 76.6%, p = 0.0487). Notably, the articaine group experienced less nasal mucosal bleeding during the surgery in contrast to the lidocaine group (p = 0.004). However, there were no statistically significant differences in changes in blood pressure and heart rate between the two groups (p > 0.05).
UNASSIGNED: This study demonstrated that 4% articaine (1:100,000 adrenaline) has superior clinical effectiveness in comparison to 2% lidocaine (1:100,000 adrenaline) in EN-DCR.

Introduction Oxidative stress, an imbalance between reactive oxygen species (ROS) production and antioxidant defenses, plays an important role in various dental diseases. Local anesthetics are frequently used in dentistry. The potential antioxidant activity of dental local anesthetics can contribute to dental practice. Therefore, this study aimed to investigate the ROS-scavenging activities of three commonly used dental local anesthetics, lidocaine, prilocaine, and articaine, focusing on their effects on hydroxyl radicals (HO•) and superoxide anions (O2 •-). Materials and methods The electron spin resonance (ESR) spin-trapping technique was employed to specifically measure the ROS-scavenging activities of these local anesthetics at varying concentrations. Results Lidocaine, prilocaine, and articaine exhibited concentration-dependent HO•-scavenging activities, with IC50 values of 0.029%, 0.019%, and 0.014%, respectively. Lidocaine and prilocaine showed concentration-dependent O2 •--scavenging activity, with IC50 values of 0.033% and 0.057%, respectively. However, articaine did not scavenge O2 •-. Conclusions The proactive use of dental local anesthetics may mitigate oxidative injury and inflammatory damage through direct ROS scavenging. However, further research is needed to elucidate the specific mechanisms underlying the antioxidant effects of these dental local anesthetics and their potential impact on the dental diseases associated with oxidative stress.

This double-blind, randomised clinical trial aimed to find out whether there is a difference in the prevalence of neurosensory disturbance (NSD) between patients who received 2% lidocaine and those who received 4% articaine during inferior alveolar nerve blocks (IANBs). Patients who underwent third molar extraction were randomised into two groups. IANB was performed using 2% lidocaine in Group 1 and 4% articaine in Group 2. The occurrence of NSD was documented. Patients were visited within 48 hours and one week after the tooth was removed. The type of anaesthetic drug (4% articaine versus 2% lidocaine) was the study\'s predictive factor. A total of 2400 patients were studied in two groups (1200 in each group). The mean (range) age of the patients was 28.40 (18-44) years. Five patients (0.41%) in the lidocaine group and seven (0.58%) in the articaine group had NSD after injection (p = 0.77). The prevalence of NSD after IANB was no higher in the articaine group than in the lidocaine group.

UNASSIGNED: The aim of this study was to compare the anesthetic efficacy of 4% articaine, 0.5% bupivacaine and 0.5% ropivacaine (with 1:200,000 adrenaline) during surgical removal of impacted mandibular third molars.
UNASSIGNED: The study included 75 patients randomly divided into three equal groups of 25 patients each. The study variables were: onset of anesthetic action, duration of surgery and anesthesia and postoperative analgesia. A visual analog scale was used to assess pain at different time intervals. Statistical analysis revealed insignificant difference among groups in terms of volume of anesthetic solution used, quality of anesthesia, surgical difficulty and duration of surgery.
UNASSIGNED: The mean onset time was significantly (P < 0.001) shorter for articaine (1.14 min) than ropivacaine (2.18 min) and bupivacaine (2.33 min). However, the duration of anesthesia as well as analgesia was significantly (P < 0.001) longer for bupivacaine (483.6 min and 464 min) and ropivacaine (426.6 min and 459 min) as compared to articaine (232.8 min and 191.4 min), respectively. Also, on comparing three groups pain scores at 6th postoperative hour were significant (P < 0.01).
UNASSIGNED: Ropivacaine and bupivacaine can be safely used in patients where longer duration of surgery is anticipated.

OBJECTIVE: This trial aimed to study the efficacy of articaine in pain management during endodontic procedures in pediatric patients.
METHODS: Ninety-eight children who received endodontic painless treatment were collected and randomly divided into the control group and observation group, with 49 cases in each group. The control group received infiltration anesthesia with lidocaine, and the observation group received infiltration anesthesia with articaine. Anesthesia effect, anesthesia onset time, sensory recovery time, duration of anesthesia, pain intensity, blood pressure, heart rate, and adverse reactions were compared.
RESULTS: The effective rate of anesthesia in the observation group was higher than that in the control group. The anesthesia onset time and sensory recovery time were shorter, the duration of anesthesia was longer, and the VAS score and facial expression score were lower in the observation group than in the control group. The heart rate of the observation group was lower, and diastolic blood pressure was higher than those of the control group. The total incidence of adverse reactions in the observation group was lower than that in the control group.
CONCLUSIONS: In the treatment of dental pulp diseases in children, the use of articaine can achieve better anesthesia effect and rapid onset of anesthesia and has less impact on the patient\'s blood pressure and heart rate, but it also can relieve pain and has good safety after the use of medication. It is worthy of clinical application.

Purpose: The safety and efficacy of a novel topical ocular anesthetic (AG-920 sterile ophthalmic solution, 8%) was previously evaluated in adults. For both clinical and regulatory purposes, this new agent was evaluated in children. Methods: This was a Phase 3, randomized, active-controlled, single-masked, parallel-group design study in healthy pediatric subjects performed at a private practice retina clinic in the United States. The safety and anesthetic efficacy of AG-920 was compared with proparacaine hydrochloride ophthalmic solution 0.5% in 60 children undergoing ophthalmic examinations. The primary efficacy endpoint was whether the investigator was able to perform the eye examination. Results: In all subjects in each treatment group, the investigator was able to perform the eye examination without additional local anesthetic. There were no adverse events reported in this study. In both the study eye and fellow eye, there were no notable changes after dosing, and both treatment groups were similar. All external eye exams in all subjects in both treatment groups were normal. Conclusions: In this pediatric population aged 7 months to >11 years, AG-920 was therapeutically equivalent to marketed proparacaine with respect to having an ophthalmic examination performed without needing additional local anesthetic. Further, AG-920 was well tolerated, and there were no clinically significant safety findings.

BACKGROUND: To compare acceptance and preference of topical lidocaine gel anesthesia with articaine injection anesthesia in patients with moderate periodontitis undergoing scaling and root debridement.
METHODS: Ninety-one patients completed this randomized multicenter split-mouth controlled study and underwent two separate periodontal treatment sessions on different days, one with a topical intrapocket lidocaine gel application and the other with an articaine injection anesthesia in a different order depending on randomization. Parameters measured were the patients\' preference for topical lidocaine gel anesthesia or injection anesthesia with articaine (primary efficacy criterion), their maximum and average pain, and their intensity of numbness as well as experience of side effects; the probing depth; and the dentists\' preference and their evaluations of handling/application, onset and duration of anesthetic effect, and patient compliance.
RESULTS: After having experienced both alternatives, 58.3% of the patients preferred the topical lidocaine gel instillation into the periodontal pockets. The safety profile of the lidocaine gel differed positively from the safety profile of articaine injection in type and frequency of adverse drug reactions. The dentists\' acceptance and preference regarding either anesthetic method studied were balanced.
CONCLUSIONS: Instillation of lidocaine gel into the periodontal pocket is a preferred alternative to injection anesthesia for most of the patients and an equivalent alternative for dentists in nonsurgical periodontal therapy.

UNASSIGNED: The objective of this research was to conduct a comparison and evaluate the pain perception and time of onset of 2% lignocaine 1:80,000 epinephrine with 4% articaine 1:100,000 epinephrine in the pediatric population.
UNASSIGNED: A split-mouth randomized control trial was conducted on 50 children aged 9-14 years who required inferior alveolar nerve block (IANB) anesthesia for bilateral dental treatment in the mandibular arch. The time of onset was recorded when no sensation was reported even when maximum electrical stimulus was applied in an electric pulp testing (EPT). The pain perception was assessed using a visual analog scale (VAS) rated by the patient for subjective symptoms and face, legs, activity, cry, and consolability (FLACC) scale for objective pain rated by the operator.
UNASSIGNED: The mean onset of time, pain-VAS, and FLACC score decreased by 1.31, 12.07, and 18.39%, respectively in 4% articaine as compared to 2% lignocaine but the difference did not reach statistical significance (p > 0.05), that is, found to be statistically the same.In conclusion, it can be inferred that the utilization of 4% articaine is as potent as 2% lignocaine solution but showed slightly better onset of anesthesia and pain experience among the children although the findings were not statistically significant.
UNASSIGNED: Local anesthesia (LA) is one of the main methods of pain management in pediatric practice which makes it essential to choose an LA agent with a shorter time of onset and less pain on administration.
UNASSIGNED: Singh SS, Koul M. A Comparative Evaluation of Pain Experience and Time of Onset of 2% Lignocaine and 4% Articaine in Inferior Alveolar Nerve Block among Pediatric Population: A Clinical Study. Int J Clin Pediatr Dent 2024;17(1):67-71.

OBJECTIVE: To assess the anesthetic efficacy of articaine with the needle-free/Comfort-in™ method compared to the conventional needle method. To assess pain during anesthesia application, onset of anesthesia and patient`s self-reported quality of life-related to oral health after the dental emergency appointment.
METHODS: This parallel, randomized clinical trial was conducted by a single operator/dentist in the state of Maranhao, northeast of Brazil. Included participants were adult dental patients with one molar (maxillary) or premolar (maxillary or mandibular) tooth diagnosed with symptomatic irreversible pulpitis. The primary outcome was the anesthetic efficacy, measured using a combination of electrical and cold pulp tests (cold + EPT) and the Numerical Rating Scale (NRS). Secondary outcomes were pain during anesthesia application, onset of anesthesia, and patient`s quality-of-life (measured with the OHIP-14).
RESULTS: 62 patients were randomized in the anesthesia needle-free group and Comfort-in group (34.26 ± 10.786 × 33.29 ± 8.399 years old, respectively). The group of patients in the Comfort-in group had 71.0% success. Patients from the Comfort-in group reported statistically lower pain during the anesthesia application than patients from the conventional group (2.13 ± 2.172 × 6.03 ± 3.146 NRS scores, respectively) as well as immediately after the anesthetic procedure. Patients self-reported negative impact in quality of life was similar between groups before (p > 0.05) and after (p > 0.05) the dental emergency.
CONCLUSIONS: Comfort-in™ had similar efficacy to the conventional needle method.
CONCLUSIONS: This trial showed that it is possible to anesthetize patients with tooth pulpits without using needles to provide comfort mainly to anxious patients.

UNASSIGNED: The inability in achieving complete pulpal anesthesia with standard buccal infiltration especially in cases with SIP used for maxillary teeth. The study aimed to compare the anesthetic efficacy of buccal and buccal plus palatal infiltration technique using 2% lidocaine and 4% articaine in permanent maxillary first molars with the diagnosis of symptomatic irreversible pulpitis (SIP).
UNASSIGNED: One hundred and twenty-three patients with clinical diagnosis of SIP, aged 18-50 years were randomly allocated to three treatment groups (N = 41). Group 1(BIL): Buccal infiltration technique using 2% lidocaine with 1:80,000 adrenaline. Group 2(BPIL): combination of buccal plus palatal infiltration using 2% Lidocaine with 1:80,000 adrenaline. Group 3(BIA): Buccal infiltration using 4% articaine with 1:100,000 adrenaline. Pain intensity of patients were recorded before and after the administration of local anesthesia during endodontic procedure that is during caries removal, access preparation and pulp removal using Heft-Parker Visual Analog Scale (HP-VAS). Success was defined by \"no pain (0 mm)\" or \"mild pain (0-54 mm)\" during endodontic procedure. The anesthetic efficacy rates were analyzed using chi-square tests, age differences using one-way ANOVA.
UNASSIGNED: The final analysis included total of 117 patients. Higher success was observed in group II (85%) in comparison to group I (69%) and group III (74%), but the difference was statistically nonsignificant (p > 0.05). Our results demonstrated a nonsignificant difference between genders in all three groups (p > 0.05).
UNASSIGNED: The use of buccal plus palatal infiltration and 4% articaine can provide effective anesthesia as standard buccal infiltration and 2% lidocaine for patients with SIP in maxillary first molars.