Articaine and lidocaine safe combo for mandibular third-molar extractions

The researchers conducted a split-mouth double-blind randomized clinical trial on 13 patients (26 samples) who were referred for elective surgical removal of bilateral impacted mandibular third molar with similar difficulty on both sides. Each patient was advised to undergo similar surgical procedures on two separate appointments.

The total sample size was divided into 2 groups: Group A where each patient randomly received 2% lidocaine for conventional inferior alveolar nerve block and 4% articaine for local infiltration before the surgery on one side and Group B was where each patient received 2% lidocaine alone (for both block anesthesia and infiltration) before the surgery on the other side. Intraoperative and postoperative variables for both groups were established and statistically analyzed.

The authors noted that the findings showed that pain on the first day after surgery in group A was significantly lower than that in group B. Also, the patients in group A mentioned experiencing less discomfort following the surgery. The increased horizontal swelling on the first- and third-days following surgery and oblique swelling on the seventh day in patients in group B were statistically significant.

Therefore, they concluded that "administering articaine and lidocaine simultaneously may lead to less pain on the day following surgery of impacted third molar. This combination of LAs may also influence the postoperative edema experienced on the first, third day, and the seventh day after surgery. Choosing an appropriate anesthetic drug for oral surgery specifically impacted third molar surgery, is dependent on the clinician's opinion, however; it seems that the combination of lidocaine and articaine may control the patient's pain significantly better than lidocaine alone."