EVALUATION OF PAIN OUTCOMES WITH ARTICAINE VERSUS LIGNOCAINE IN THE ENDODONTIC AND SURGICAL MANAGEMENT OF IRREVERSIBLE PULPITIS IN MAXILLARY FIRST MOLARS

Abstract

Background: Untreated caries leading to cavity formation was one of the most common dental diseases internationally affecting 2.4 billion people in the year 2010. Irreversible pulpitis is one of the most common dental diseases in Pakistan with a prevalence of 19.4 percent according to one study. Maxillary molars are one of the most commonly affected teeth by irreversible pulpitis. They are also considered the cornerstone of occlusion and the tooth with the most stable anatomy. The management of irreversible pulpitis involves pulp extirpation and exodontia.

Objectives: Assessment of Pain Levels in Root Canal and Extraction Procedures Using Articaine and Lignocaine Buccal Infiltration in Maxillary First Molars with Irreversible Pulpitis

Methods:  It is randomized clinical study conducted at Pharmacology department, Islamic International Medical College Rawalpindi with support Margalla Institute of Health Sciences. The duration of study was one year. 240 patients who were being treated for irreversible pulpitis in first upper molars  randomly divided into two Groups, Group 1 and 2. Group 1 were the patients given the specific local anesthesia for pulp extirpation (root canal treatment). Group 2 were the patients given the local anesthetic for exodontia (dental extractions). These groups were divided further into four groups. Group A and Group B were managed by pulp extirpation (root canal) and were given Lignocaine and Articaine respectively. Group C and Group D were managed by exodontia (dental extraction) and were anesthetized using Lignocaine and Articaine respectively. The intensity of pain reported by the patient  during injection and the pain felt during the procedure was determined by the VAS.

Results: Significantly less pain was experienced by the Group B and Group D patients as compared to Group A and C during the procedure. There was no statically significant difference in the pain experienced by the patients during the injection.

Conclusion: Articaine causes marked decrease in the pain experienced during the procedure and it can be used in the management of irreversible pulpitis.