The purpose of the present study was to compare the anesthetic efficacy of 4% articaine
with 1:100,000 epinephrine with that of 2% lidocaine with 1:100,000 epinephrine during
pulpectomy in patients with irreversible pulpitis in mandibular posterior teeth. Forty
volunteers, patients with irreversible pulpitis admitted to the Emergency Center of
the School of Dentistry at the University of São Paulo, randomly received a conventional
inferior alveolar nerve block containing 3.6 mL of either 4% articaine with 1:100,000
epinephrine or 2% lidocaine with 1:100,000 epinephrine. During the subsequent pulpectomy,
we recorded the patients' subjective assessments of lip anesthesia, the absence/presence
of pulpal anesthesia through electric pulp stimulation, and the absence/presence of
pain through a verbal analogue scale. All tested patients reported lip anesthesia
after the application of either inferior alveolar nerve block. Regarding pulpal anesthesia
success as measured with the pulp tester, the lidocaine solution had a higher success
rate (70%) than the articaine solution (65%). For patients reporting none or mild
pain during pulpectomy, the success rate of the articaine solution (65%) was higher
than that of the lidocaine solution (45%). Yet, none of the observed differences between
articaine and lidocaine were statistically significant. Apparently, therefore, both
local anesthetic solutions had similar effects on the patients with irreversible pulpitis
in mandibular posterior teeth. Neither of the solutions, however, resulted in an effective
pain control during irreversible pulpitis treatments.