Comparative Efficacy of 27-gauge and 30-gauge Needles in Inferior Alveolar Nerve Block Using Articaine and Lignocaine: A Randomized Controlled Trial

Aim and background:The inferior alveolar nerve block (IANB) is frequently employed in mandibular dental procedures and its success is influenced by various factors, including needle gauge and anesthetic agent.The aim of this randomized controlled trial was to assess the effectiveness of 27-gauge and 30-gauge needles with articaine and lignocaine in terms of success rate, onset time, duration of effective anesthesia, pain, and comfort as reported by patients.Materials and methods: A double-blind, randomized controlled trial was carried out at a dental teaching hospital with 100 healthy adults (18-60 years old) who needed IANB for mandibular molars.Participants were divided randomly into four groups: 27-gauge needle with lignocaine, 30-gauge needle with lignocaine, 27-gauge needle with articaine, and 30-gauge needle with articaine.Success rates (pulpal anesthesia in 15 minutes) were primary outcomes; onset time, duration of anesthesia, and pain during needle insertion measured via visual analog scale (VAS) were secondary outcomes.Results: There was significantly higher success rate with articaine when compared with lignocaine (p < 0.001) with the highest being with 30-gauge needle with articaine (92%).The onset time of articaine (2.8 ± 0.6 minutes for 30-gauge needles) was quicker than that of lignocaine.In terms of pain, scores during insertion were significantly lower with 30-gauge needles with articaine (p < 0.001).The duration of anesthesia was longest with articaine and 30-gauge needles (116 ± 8 minutes).Conclusion: Articaine, especially when utilized with 30-gauge needles, delivers far superior clinical outcomes, such as greater success rates, reduced onset time, increased duration of anesthesia, and less pain during anesthetic injection.Clinical significance: These findings emphasize the need for choosing appropriate needle gauges and anesthetic agents to increase successful outcomes in IANB.The superior performance of 30-gauge needles with articaine presents an adjunct avenue to improve patient care and procedural efficiency in dentistry.