The purpose of this study is to determine if there is a difference between the rate of missed inferior alveolar nerve blocks between 4% articaine and 2% lidocaine both with 1:100,000 epinephrine.
Using a double-blinded, prospective, controlled clinical trial design 2 operators administered 217 inferior alveolar nerve blocks and recorded whether or not the patient reported subjective numbness of the ipsilateral lower lip within 15 minutes. We also verified soft-tissue anesthesia with a pin-prick test.
The number of missed injections for 4% articaine was 4 compared to 8 for 2% lidocaine resulting in a miss rate of 4.2% for 4% articaine and 6.6% for 2% lidocaine. These were not significantly different (p = 0.5555). The number of injections failing to obtain profound soft tissue anesthesia was 9 for 4% articaine compared to 18 for 2% lidocaine resulting in a miss rate of 9.4% for 4% articaine and 14.9% for 2% lidocaine. These were not significantly different (p = 0.3008).
With the limited number of missed blocks obtained in this study, we were unable to find a statistically significant difference between the two solutions tested. More research subjects should be completed to enhance the statistical power to determine the difference in rates if one exists or to be able to draw the conclusion that there is no difference.