Anaesthetic Efficacy of 2% Mepivacaine Versus 4% Articaine With Symptomatic Irreversible Pulpitis

Anaesthetic Efficacy of 2% Mepivacaine Versus 4% Articaine for Inferior Alveolar Nerve Blocks in Patients With Symptomatic Irreversible Pulpitis in Mandibular Molars: A Randomized Clinical Trial

Status

Completed

Phases

Study type

Interventional

Source

ClinicalTrials.gov

Registry ID

NCT04822415

Enrollment

330

Registered

2021-03-30

Start date

2014-12-31

Completion date

2016-12-31

Last updated

2021-08-02

For informational purposes only — not medical advice. Sourced from public registries and may not reflect the latest updates. Terms

Conditions

Symptomatic Irreversible Pulpitis

Brief summary

Detailed description

The aim of this randomized, double-blinded, clinical trial was to assess the effect of 3.6 mL 2% mepivacaine hydrochloride with 1:100,000 epinephrine compared to 3.4 mL 4% articaine hydrochloride with 1:100,000 epinephrine on the success of the inferior alveolar nerve block for patients with symptomatic irreversible pulpitis in mandibular molars. Patients were clinically and radiographically examined and their eligibility assessed and preoperative pain was measured using the numerical rating scale (NRS). Patients were randomly assigned to one of 2 groups: experimental group (2% mepivacaine) and the control group (4% articaine). After 15 minutes of the inferior alveolar nerve block (IANB), patients reporting lip numbness had their molars accessed. No-to-mild pain response was considered success during root canal preparation.

Interventions

DRUGMepivacaine

IANB using 3.6 ml of 2% mepivacaine hydrochloride with 1:100,000 epinephrine.

DRUGArticaine

IANB using 3.4 ml of 4% articaine hydrochloride with 1:100,000 epinephrine.

Study design

Allocation

RANDOMIZED

Intervention model

PARALLEL

Primary purpose

PREVENTION

Masking

QUADRUPLE (Subject, Caregiver, Investigator, Outcomes Assessor)

Eligibility

Sex/Gender

ALL

Age

18 Years to 50 Years

Healthy volunteers

Inclusion criteria

* Patients in good health (American Society of Anesthesiologists Class I or II). * Patients having symptomatic irreversible pulpitis in one of their mandibular molars. * Age range between 18 to 50 years. * Patients who can understand Numerical Rating Scale (NRS). * Positive patient acceptance and the ability to sign an informed consent.

Exclusion criteria

* Pregnant females. * Patients allergic to articaine, mepivacaine and/or any used medication or material. * Patients having active sites of pathosis in the area of injection. * Patients having active pain in more than one molar. * Patients who had taken analgesics in the 12 hours preceding treatment.

Design outcomes

Primary

Measure	Time frame	Description
Anaesthetic success	Intraoperative	Success of mandibular inferior alveolar nerve block anesthesia during access cavity preparation and instrumentation measured using the 11-point numerical rating scale (NRS) so that no-or-mild pain is considered as anesthetic success and moderate-to-severe pain is considered anesthetic failure.

Secondary

Measure	Time frame	Description
Need for Supplemental anaesthesia	Intraoperative	The need for supplemental anaesthesia to complete treatment (Yes/No).

Outcome results

None listed

Source: ClinicalTrials.gov · Data processed: Feb 4, 2026