Articaine provides a faster onset and longer duration of analgesia at lower supplemental injections compared to mepivacaine in third molar extractions.

Purpose: This study compared the anesthetic efficacy of mepivacaine and articaine in third molar extractions.

Methods: In this split-mouth, single-blind, randomized controlled trial, 36 patients underwent extraction of all four third molars. Each patient received two different local anesthetics: one side was anesthetized with 2% mepivacaine with epinephrine (1:100,000), and the other with 4% articaine with epinephrine (1:100,000). Anesthesia was administered using three cartridges per hemiarch to achieve analgesia for both maxillary and mandibular third molars. The number of supplemental anesthetic cartridges used, the onset and duration of anesthesia, and intraoperative pain (measured using the Visual Analog Scale [VAS]) were recorded.

Results: The side anesthetized with articaine demonstrated a significantly shorter onset time (p < 0.05) and a longer duration of analgesia (p < 0.01) compared to the mepivacaine side. Fewer supplemental cartridges were required when articaine was used (p < 0.05). Patients did not report significant differences in perceived pain between the mepivacaine and articaine sides (p > 0.05).

Conclusion: It can be concluded that articaine provides a faster onset and a longer duration of anesthesia lower supplemental injections compared to mepivacaine.