Retrospective comparison of local anesthesia for mandibular molars: articaine buccal infiltration vs. lidocaine intraosseous anesthesia

Abstract Objectives It is vital to identify more efficient anesthesia techniques for restorative or endodontic treatments of mandibular molars. Both articaine buccal infiltration anesthesia (ABI) and lidocaine inferior alveolar nerve block anesthesia (LIANB) may not provide profound anesthesia, necessitating supplementary anesthesia. This study aims to investigate whether lidocaine intraosseous (LIO) injection, compared to ABI, is suitable for primary anesthesia for caries treatments of mandibular molars. Materials and Methods This study retrospectively analyzed on patients for the treatment of advanced caries corresponding to the International Caries Detection and Assessment System (ICDAS) 5 and 6. The study involved 48 patients, split evenly between those receiving ABI and LIO, examining anesthesia success rate, pain during anesthesia, onset time, duration, and lower lip numbness, with data analyzed using Chi-square and Independent T-tests. Results In the ABI group, 17 individuals (70.8%) did not require additional anesthesia, whereas all 24 individuals (100%) in the LIO group did not require additional anesthesia (P<.001). ABI showed significantly higher pain during anesthesia, slower onset time, and longer duration of anesthesia compared to LIO. There was no significant difference in lower lip numbness between the two anesthesia methods. Conclusions For treating severe caries in mandibular molars, intraosseous anesthesia using lidocaine is more effective for its higher success rate, decreased pain during anesthesia, faster onset, and shorter recovery time. Clinical Relevance The findings of this study suggest that LIO may be considered as a primary anesthesia method for mandibular molar caries treatments in clinical practice, providing beneficial effects for patients.