Articaine Versus Lidocaine for Supplemental Buccal Infiltration in Lower First Molars With Irreversible Pulpitis

Summary

Local anesthetic is used to numb a tooth before a root canal treatment. In lower back teeth with irreversible pulpitis (a painful, inflamed tooth nerve), the standard numbing injection near the jaw nerve, called an inferior alveolar nerve block, often does not numb the tooth enough. When this happens, patients may feel pain during treatment, and dentists often give an extra injection beside the tooth. This study compares two numbing medicines used for that extra injection: 4% articaine and 2% lidocaine, both with epinephrine. Articaine is a newer medicine that may pass through bone more easily, but it is not clear whether it works better than lidocaine in this situation. Adults aged 18 to 50 with a painful lower first molar needing a root canal first receive the standard nerve block with lidocaine. Patients who still feel pain when the dentist begins opening the tooth then receive an extra injection beside the tooth, with either articaine or lidocaine. Which medicine is given is decided by chance, and neither the patient nor the dentist knows which one it is.

Timeline

Start

2026-03-03

Primary completion

2026-08-07

Completion

2026-08-27

Drugs

Indications