Evaluation of the Anesthetic Efficacy and Pain Control of Buffered 4% Articaine in Mandibular Molar Tooth Preparation

Year 2025, Volume: 26 Issue: 3, 356 - 362, 22.09.2025

Goknil Alkan Demetoğlu , Hüseyin Şeker

https://doi.org/10.69601/meandrosmdj.1721467

Abstract

This study aimed to evaluate whether buccal infiltration anesthesia with sodium bicarbonate-buffered articaine provides comparable or superior anesthetic efficacy to traditional inferior alveolar nerve block (IANB) in mandibular molar tooth preparations, while minimizing complications and enhancing patient comfort.
Materials and Methods
A randomized clinical trial was conducted with 75 healthy adult participants requiring mandibular molar prosthetic treatment. Patients were randomly assigned to three groups:
• Group M: IANB with 4% articaine + 1:100,000 epinephrine
• Group I: Buccal infiltration with the same articaine formulation
• Group SB: Buffered buccal infiltration (2% articaine + 0.84% sodium bicarbonate + 1:200,000 epinephrine)
Pain was measured using Visual Analog Scale (VAS1: during treatment, VAS2: next day), and heart rate was monitored before and during the procedure.
Results
VAS1 scores were significantly higher in Group I (p < .001), indicating more pain during treatment. Group SB had significantly lower VAS2 scores, reflecting reduced postoperative discomfort. No significant differences in heart rate were found across groups.
Conclusion
Buffered articaine with sodium bicarbonate used for buccal infiltration in mandibular molars showed anesthetic efficacy comparable to IANB, with less pain and fewer complications. This approach may serve as a safer and more comfortable alternative to nerve block anesthesia in routine prosthetic procedures.

Keywords

buffered Articaine , buccal infiltration , inferior alveolar nerve block , mandibular molars , pain control

Mandibular Molar Diş Preperasyonunda Tamponlanmış %4 Artikaine'in Anestezik Etkinliği ve Ağrı Kontrolünün Değerlendirilmesi

Abstract

Amaç: Bu çalışmanın amacı, sodyum bikarbonat ile tamponlanmış artikain ile yapılan bukkal infiltrasyon anestezisinin, mandibular molar diş kesiminde geleneksel inferior alveolar sinir bloğuna (IANB) karşı etkinliğini ve hasta konforunu değerlendirmektir.
Gereç ve Yöntem: Alt çene molar dişlerinde protetik tedavi gereken 75 sağlıklı erişkin birey rastgele üç gruba ayrıldı:
Grup M: 4% artikain + 1:100,000 epinefrin ile IANB
Grup I: Aynı içerikle bukkal infiltrasyon
Grup SB: Tamponlanmış bukkal infiltrasyon (2% artikain + %0.84 sodyum bikarbonat + 1:200,000 epinefrin)
Ağrı düzeyleri Görsel Analog Skala (VAS) ile ölçüldü (VAS1: işlem sırasında, VAS2: ertesi gün) ve işlem öncesi/sonrası nabız değerleri kaydedildi.
Bulgular: VAS1 skorları en yüksek Grup I’deydi (p < .001). VAS2 skorları en düşük Grup SB’de bulundu (p < .05). Gruplar arasında nabız değişiminde anlamlı fark saptanmadı.
Sonuç: Sodyum bikarbonatla tamponlanmış artikain kullanımı, mandibular molarlarda uygulanan bukkal infiltrasyon anestezisinde IANB ile benzer etkinlik gösterdi. Daha az ağrı ve komplikasyon ile bu yöntem, rutin protetik işlemler için etkili ve konforlu bir alternatif olabilir.

Keywords

Tamponlanmış artikain , Bukkal infiltrasyon , İnferior alveolar sinir bloğu , Mandibular molar dişler , Ağrı kontrolü

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