Articaine Needle - Free Anesthesia Vs Conventional Anesthesia in Root Canal Treatment of Irreversible Pulpitis in Permanent Teeth: A Prospective Study on Anesthetic Efficacy and Effects on Pain.

Objective: This study aimed to compare the anesthetic efficacy of articaine needle-free anesthesia with conventional lidocaine nerve block anesthesia for root canal treatment in permanent teeth with irreversible pulpitis.

Methods: In this prospective clinical trial, 94 patients were randomly allocated to receive either articaine needle-free anesthesia (n=47) or lidocaine nerve block anesthesia (n=47). Anesthetic effectiveness was evaluated through onset time, success rate, and visual analog scale (VAS) pain scores during crown opening and pulp removal procedures. Secondary outcomes included hemodynamic stability (heart rate, systolic and diastolic blood pressure) and incidence of adverse reactions.

Results: The articaine group exhibited significantly faster anesthesia onset (7.62±1.28 minutes vs 9.35±2.04 minutes, p<0.05) and higher success rate (93.62% vs 80.85%, p<0.05). Patients receiving articaine reported significantly lower pain scores during crown opening (4.31±1.13 vs 5.48±1.06) and pulp removal (3.18±1.07 vs 4.26±1.12) (both p<0.05). Both groups maintained comparable hemodynamic stability throughout the procedure (p>0.05), with no significant difference in adverse reaction rates (11.49% vs 10.64%, p>0.05).

Conclusion: Articaine needle-free anesthesia demonstrates superior clinical performance compared to conventional lidocaine nerve block, offering faster onset, improved success rate, and enhanced pain control during root canal treatment of irreversible pulpitis, while maintaining equivalent safety parameters. These findings support its adoption as an effective alternative for dental anesthesia in endodontic procedures.