Evaluation of the Anesthetic Efficacy and Pain Control of Buffered 4% Articaine in Mandibular Molar Tooth Preparation

This study aimed to evaluate whether buccal infiltration anesthesia with sodium bicarbonate-buffered articaine provides comparable or superior anesthetic efficacy to traditional inferior alveolar nerve block (IANB) in mandibular molar tooth preparations, while minimizing complications and enhancing patient comfort. Materials and Methods A randomized clinical trial was conducted with 75 healthy adult participants requiring mandibular molar prosthetic treatment. Patients were randomly assigned to three groups: • Group M: IANB with 4% articaine + 1:100,000 epinephrine • Group I: Buccal infiltration with the same articaine formulation • Group SB: Buffered buccal infiltration (2% articaine + 0.84% sodium bicarbonate + 1:200,000 epinephrine) Pain was measured using Visual Analog Scale (VAS1: during treatment, VAS2: next day), and heart rate was monitored before and during the procedure. Results VAS1 scores were significantly higher in Group I (p < .001), indicating more pain during treatment. Group SB had significantly lower VAS2 scores, reflecting reduced postoperative discomfort. No significant differences in heart rate were found across groups. Conclusion Buffered articaine with sodium bicarbonate used for buccal infiltration in mandibular molars showed anesthetic efficacy comparable to IANB, with less pain and fewer complications. This approach may serve as a safer and more comfortable alternative to nerve block anesthesia in routine prosthetic procedures.