Comparative Evaluation of Pain Control Using 4% Articaine Buccal Infiltration and 2% Lignocaine Inferior Alveolar Nerve Block for Pulpectomy in Primary Mandibular Second Molars in the Children of Age-group 6-10 Years: A Split-mouth Randomized Controlled Clinical Trial.

Aims: This study aims to evaluate pain control using 4% articaine buccal infiltration and 2% lignocaine inferior alveolar nerve block (IANB) for pulpectomy in primary mandibular second molars in children of age category of 6-10 years.

Background: In pediatric dentistry, one of the most significant aspects of child behavior management is pain control during injecting local anesthesia. This leads to building trust, allaying fear or anxiety, and promoting a positive dental attitude. IANB is the preferred technique for achieving pulpal anesthesia during the treatment of mandibular primary molars. About 2% lignocaine is the most commonly used anesthetic agent in dentistry. Administration of 2% lignocaine using IANB is difficult in pediatric patients, as it may lead to uncooperative behavior in child, whereas administration of 4% articaine through buccal infiltration is comparatively more feasible in child and also reduces the postoperative complications. Hence, this study aims to compare pain control using 2% lignocaine IANB and 4% articaine buccal infiltration.

Materials and methods: Children between 6 and 10 years were selected for the study. It was split-mouth randomized controlled clinical trial. About 40 primary mandibular second molars were randomized from 20 children. Two categories were as follows: (1) category A-4% articaine buccal infiltration was administered and then pulpectomy procedure was performed, and (2) category B-2% lignocaine IANB was administered and then pulpectomy procedure was performed.

Results: It indicated that 4% articaine buccal infiltration had a lower mean pain score than 2% lignocaine IANB using Wong-Baker's face pain scale for objective evaluation and comparing subjective mean pain scores using Modified Behavioral Pain Scale (MBPS) during pulpectomy procedure.

Conclusion: (1) Pulpectomy is possible by depositing 4% articaine buccal infiltration. Articaine is an effective local anesthetic and can be used as an alternative to lignocaine nerve block in children. (2) No significant adverse effects were observed after the use of 4% articaine.

Clinical significance: Articaine is an effective local anesthetic and can be used as an alternative to lignocaine in children. Delivering comfortable anesthesia is essential, as it increases both patient's trust and treatment acceptance while at the same time reducing personal stress level.

How to cite this article: Saple RP, Pustake BJ, Patil S, et al. Comparative Evaluation of Pain Control Using 4% Articaine Buccal Infiltration and 2% Lignocaine Inferior Alveolar Nerve Block for Pulpectomy in Primary Mandibular Second Molars in the Children of Age-group 6-10 Years: A Split-mouth Randomized Controlled Clinical Trial. Int J Clin Pediatr Dent 2025;18(5):491-499.