Comparative Evaluation of Alveolar Nerve Block with 2% Lidocaine–Epinephrine and 4% Articaine–Epinephrine Buccal Infiltration in Mandibular Premolar and Molar Region in Children: A Double-Blind, Randomized Trial

<b>Background/Objectives</b>: Effective pain control in pediatric dentistry combines behavior management, local anesthesia, and follow-up care. This study compared the efficacy of inferior alveolar nerve block (IANB) with 2% lidocaine and epinephrine versus buccal infiltration (BI) with...

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Main Authors: Jelena Komsic, Sanja Vujkov, Isidora Neskovic, Duska Blagojevic, Ana Tadic, Bojan Petrovic, Branislav Bajkin
Format: Article
Language:English
Published: MDPI AG 2025-02-01
Series:Children
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Online Access:https://www.mdpi.com/2227-9067/12/2/215
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author Jelena Komsic
Sanja Vujkov
Isidora Neskovic
Duska Blagojevic
Ana Tadic
Bojan Petrovic
Branislav Bajkin
author_facet Jelena Komsic
Sanja Vujkov
Isidora Neskovic
Duska Blagojevic
Ana Tadic
Bojan Petrovic
Branislav Bajkin
author_sort Jelena Komsic
collection DOAJ
description <b>Background/Objectives</b>: Effective pain control in pediatric dentistry combines behavior management, local anesthesia, and follow-up care. This study compared the efficacy of inferior alveolar nerve block (IANB) with 2% lidocaine and epinephrine versus buccal infiltration (BI) with 4% articaine and epinephrine in treating primary molars, permanent premolars, and molars in children. <b>Methods</b>: Sixty children aged 5–18 years were randomly assigned to two groups in a double-blind study. One group received 1.7 mL BI with 4% articaine, and the other 1.8 mL IANB with 2% lidocaine for dental treatment. Pain was assessed using the self-reported Visual Analog Scale (VAS) and Wong–Baker Faces Pain Rating Scale (W-BFRS), while anesthesia effectiveness and behavior were evaluated using the Frankl Behavior Rating Scale (FBRS) and vitality tests. <b>Results</b>: The articaine group reported significantly lower pain scores on all scales (VAS: 1.23 ± 2.01; FBRS: 0.47 ± 0.57; W-BFRS: 1.33 ± 2.04) than the lidocaine group (VAS: 3.17 ± 1.64; FBRS: 1.26 ± 0.45; W-BFRS: 3.17 ± 1.64). Articaine also outperformed lidocaine in secondary measures, with higher positive responses on the questionnaires (articaine: 8.37 ± 1.61 vs. lidocaine: 5.27 ± 1.41, <i>p</i> < 0.001). <b>Conclusions</b>: Buccal infiltration with 4% articaine is more effective than 2% lidocaine administered via IANB for invasive dental procedures in children, providing superior pain control and positive patient responses.
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spelling doaj-art-e643beab472e481ca9b1c03ddfaa05cd2025-08-20T02:44:41ZengMDPI AGChildren2227-90672025-02-0112221510.3390/children12020215Comparative Evaluation of Alveolar Nerve Block with 2% Lidocaine–Epinephrine and 4% Articaine–Epinephrine Buccal Infiltration in Mandibular Premolar and Molar Region in Children: A Double-Blind, Randomized TrialJelena Komsic0Sanja Vujkov1Isidora Neskovic2Duska Blagojevic3Ana Tadic4Bojan Petrovic5Branislav Bajkin6Department of Dentistry, Medical Faculty, University of Novi Sad, 21000 Novi Sad, SerbiaDepartment of Dentistry, Medical Faculty, University of Novi Sad, 21000 Novi Sad, SerbiaDepartment of Dentistry, Medical Faculty, University of Novi Sad, 21000 Novi Sad, SerbiaDepartment of Dentistry, Medical Faculty, University of Novi Sad, 21000 Novi Sad, SerbiaDepartment of Dentistry, Medical Faculty, University of Novi Sad, 21000 Novi Sad, SerbiaDepartment of Dentistry, Medical Faculty, University of Novi Sad, 21000 Novi Sad, SerbiaDepartment of Dentistry, Medical Faculty, University of Novi Sad, 21000 Novi Sad, Serbia<b>Background/Objectives</b>: Effective pain control in pediatric dentistry combines behavior management, local anesthesia, and follow-up care. This study compared the efficacy of inferior alveolar nerve block (IANB) with 2% lidocaine and epinephrine versus buccal infiltration (BI) with 4% articaine and epinephrine in treating primary molars, permanent premolars, and molars in children. <b>Methods</b>: Sixty children aged 5–18 years were randomly assigned to two groups in a double-blind study. One group received 1.7 mL BI with 4% articaine, and the other 1.8 mL IANB with 2% lidocaine for dental treatment. Pain was assessed using the self-reported Visual Analog Scale (VAS) and Wong–Baker Faces Pain Rating Scale (W-BFRS), while anesthesia effectiveness and behavior were evaluated using the Frankl Behavior Rating Scale (FBRS) and vitality tests. <b>Results</b>: The articaine group reported significantly lower pain scores on all scales (VAS: 1.23 ± 2.01; FBRS: 0.47 ± 0.57; W-BFRS: 1.33 ± 2.04) than the lidocaine group (VAS: 3.17 ± 1.64; FBRS: 1.26 ± 0.45; W-BFRS: 3.17 ± 1.64). Articaine also outperformed lidocaine in secondary measures, with higher positive responses on the questionnaires (articaine: 8.37 ± 1.61 vs. lidocaine: 5.27 ± 1.41, <i>p</i> < 0.001). <b>Conclusions</b>: Buccal infiltration with 4% articaine is more effective than 2% lidocaine administered via IANB for invasive dental procedures in children, providing superior pain control and positive patient responses.https://www.mdpi.com/2227-9067/12/2/215dental anesthesiainferior alveolar nervebuccal administrationarticainelidocainepediatrics
spellingShingle Jelena Komsic
Sanja Vujkov
Isidora Neskovic
Duska Blagojevic
Ana Tadic
Bojan Petrovic
Branislav Bajkin
Comparative Evaluation of Alveolar Nerve Block with 2% Lidocaine–Epinephrine and 4% Articaine–Epinephrine Buccal Infiltration in Mandibular Premolar and Molar Region in Children: A Double-Blind, Randomized Trial
Children
dental anesthesia
inferior alveolar nerve
buccal administration
articaine
lidocaine
pediatrics
title Comparative Evaluation of Alveolar Nerve Block with 2% Lidocaine–Epinephrine and 4% Articaine–Epinephrine Buccal Infiltration in Mandibular Premolar and Molar Region in Children: A Double-Blind, Randomized Trial
title_full Comparative Evaluation of Alveolar Nerve Block with 2% Lidocaine–Epinephrine and 4% Articaine–Epinephrine Buccal Infiltration in Mandibular Premolar and Molar Region in Children: A Double-Blind, Randomized Trial
title_fullStr Comparative Evaluation of Alveolar Nerve Block with 2% Lidocaine–Epinephrine and 4% Articaine–Epinephrine Buccal Infiltration in Mandibular Premolar and Molar Region in Children: A Double-Blind, Randomized Trial
title_full_unstemmed Comparative Evaluation of Alveolar Nerve Block with 2% Lidocaine–Epinephrine and 4% Articaine–Epinephrine Buccal Infiltration in Mandibular Premolar and Molar Region in Children: A Double-Blind, Randomized Trial
title_short Comparative Evaluation of Alveolar Nerve Block with 2% Lidocaine–Epinephrine and 4% Articaine–Epinephrine Buccal Infiltration in Mandibular Premolar and Molar Region in Children: A Double-Blind, Randomized Trial
title_sort comparative evaluation of alveolar nerve block with 2 lidocaine epinephrine and 4 articaine epinephrine buccal infiltration in mandibular premolar and molar region in children a double blind randomized trial
topic dental anesthesia
inferior alveolar nerve
buccal administration
articaine
lidocaine
pediatrics
url https://www.mdpi.com/2227-9067/12/2/215
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