Evaluation of the Efficacy of Conduction Anesthesia Using Low-Concentration Local Anesthetics in Dentistry

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Study Subject: The study focuses on the anesthetic efficacy of 2 ml of 20 mg/ml (2%) articaine solution (Joint-stock company «Binergia») compared with 2 ml of 20 mg/ml (2%) lidocaine hydrochloride solution. Objective: To perform a comparative assessment of the effectiveness of conduction anesthesia of the third branch of the trigeminal nerve using articaine- and lidocaine-based local anesthetics. Methodology: Patients were randomly assigned to two equal groups of 20 each. The first group received 2 ml injections of 20 mg/ml articaine hydrochloride solution, while the second group was administered 2 ml of 20 mg/ml lidocaine hydrochloride solution. The primary indication for local anesthesia was ICD-10 code K10.2: Inflammatory diseases of the jaws (periostitis). Local anesthetic dosages did not exceed half the maximum allowable dose for each patient, considering individual body weight. The main efficacy endpoints included • Level of analgesia measured by the Visual Analog Scale (VAS) within 10 minutes of anesthetic administration; • Onset time of anesthesia, defined as the moment of loss of pain sensitivity within the area of innervation; • Duration of analgesia, measured from the onset of anesthesia to the return of sensitivity. Results: The study demonstrated the clinical effectiveness of both local anesthetic solutions—20 mg/ml (2%) lidocaine and 20 mg/ml (2%) articaine — for conduction anesthesia in patients with purulent-inflammatory diseases of the maxillofacial region. For deep inflammatory foci, 20 mg/ml (2%) articaine is preferable. For short-term procedures, especially in patients with specific risk factors, utilization of 20 mg/ml (2%) lidocaine may be appropriate. Conclusions: 1. Administration of 20 mg/ml (2%) lidocaine solution for local anesthesia in the presence of inflammation provides a moderate reduction in VAS scores, likely due to its anti-inflammatory properties. 2. The use of 20 mg/ml (2%) lidocaine hydrochloride solution offers reliable anesthesia and assists in inflammation control, thus improving postoperative outcomes as observed during the postoperative period. 3. It was found that 20 mg/ml (2%) lidocaine hydrochloride has a shorter duration of action (125 ± 14 min) compared to 20 mg/ml (2%) articaine hydrochloride (175 ± 23 min), which is an important consideration when planning postoperative care.