Non-Cochrane · intervention · PM41998511
Efficacy comparison of articaine versus lidocaine in dental anesthesia: a meta-analysis of randomized controlled trials.
Gong Hongjun, Wu Qi, Wu Qingping, et al. · BMC anesthesiology · 2026 · PubMed · doi:10.1186/s12871-026-03831-x
Findings
58 findings
| Population | ||||
|---|---|---|---|---|
| Adults (18 years or older) requiring dental procedures (extraction, pulpitis, caries) | 4% articaine with epinephrine, infiltration anesthesia | 2% lidocaine with epinephrine, infiltration anesthesia | Anesthetic onset time (min) Dental procedures; infiltration anesthesia · Premolar | MD -1.81 [-2.85, -0.78] GRADE not reported 5 studies |
| Adults (18 years or older) requiring dental procedures (extraction, pulpitis, caries) | 4% articaine with epinephrine, infiltration anesthesia | 2% lidocaine with epinephrine, infiltration anesthesia | Anesthetic success rate Dental procedures; infiltration anesthesia · Premolar | RR 1.05 [0.9, 1.23] GRADE not reported 3 studies |
| Adults (18 years or older) requiring dental procedures (extraction, pulpitis, caries) | 4% articaine with epinephrine, infiltration anesthesia | 2% lidocaine with epinephrine, infiltration anesthesia | Anesthetic duration (min) Dental procedures; infiltration anesthesia · Premolar | MD 27.34 [9.52, 45.16] GRADE not reported 4 studies |
| Adults (18 years or older) requiring dental procedures (extraction, pulpitis, caries) | 4% articaine with epinephrine, infiltration anesthesia | 2% lidocaine with epinephrine, infiltration anesthesia | Pain intensity (VAS) Dental procedures; infiltration anesthesia · Molar | MD -2.38 [-3.43, -1.33] GRADE not reported 3 studies |
| Adults (>=18 years) requiring dental procedures (tooth extraction, caries, pulpitis) | 4% articaine with epinephrine, infiltration anesthesia | 2% lidocaine with epinephrine, infiltration anesthesia | Anesthetic success rate Dental clinics; extraction, pulpitis and endodontic pain models | RR 1.03 [0.98, 1.08] 24 [-16, 63] more per 1000 Moderate Downgraded: imprecision 12 studies · 989 participants |
| Adults (18 years or older) requiring dental procedures (extraction, pulpitis, caries) | 4% articaine with epinephrine, infiltration anesthesia | 2% lidocaine with epinephrine, infiltration anesthesia | Anesthetic success rate Dental procedures; infiltration anesthesia · Supplemental anesthesia required | RR 1.04 [0.95, 1.13] GRADE not reported 5 studies |
| Adults (18 years or older) requiring dental procedures (extraction, pulpitis, caries) | 4% articaine with epinephrine, infiltration anesthesia | 2% lidocaine with epinephrine, infiltration anesthesia | Anesthetic success rate Dental procedures; infiltration anesthesia · Lidocaine with 1:80,000 epinephrine | RR 1.01 [0.88, 1.16] GRADE not reported 5 studies |
| Adults (18 years or older) requiring dental procedures (extraction, pulpitis, caries) | 4% articaine with epinephrine, infiltration anesthesia | 2% lidocaine with epinephrine, infiltration anesthesia | Anesthetic onset time (min) Dental procedures; infiltration anesthesia · Molar | MD -0.57 [-0.99, -0.16] GRADE not reported 2 studies |
| Adults (>=18 years) requiring dental procedures (tooth extraction, caries, pulpitis) | 4% articaine with epinephrine, infiltration anesthesia | 2% lidocaine with epinephrine, infiltration anesthesia | Pain intensity (VAS) Dental clinics; extraction, pulpitis and endodontic pain models | MD -4.41 [-7.62, -1.21] -4.41 [-7.62, -1.21] VAS points Moderate Downgraded: imprecision 7 studies · 418 participants |
| Adults (18 years or older) requiring dental procedures (extraction, pulpitis, caries) | 4% articaine with epinephrine, infiltration anesthesia | 2% lidocaine with epinephrine, infiltration anesthesia | Pain intensity (VAS) Dental procedures; infiltration anesthesia · SCI-indexed journals | MD -5.2 [-8.01, -2.38] GRADE not reported 3 studies |
| Adults (18 years or older) requiring dental procedures (extraction, pulpitis, caries) | 4% articaine with epinephrine, infiltration anesthesia | 2% lidocaine with epinephrine, infiltration anesthesia | Pain intensity (VAS) Dental procedures; infiltration anesthesia · Non-SCI-indexed journals | MD -3.16 [-6.09, -0.23] GRADE not reported 7 studies |
| Adults (>=18 years) requiring dental procedures (tooth extraction, caries, pulpitis) | 4% articaine with epinephrine, infiltration anesthesia | 2% lidocaine with epinephrine, infiltration anesthesia | Anesthetic duration Dental clinics; extraction, pulpitis and endodontic pain models | MD 18.68 [3.05, 34.30] 18.68 [3.05, 34.3] minutes Moderate Downgraded: risk of bias 7 studies · 476 participants |
| Adults (18 years or older) requiring dental procedures (extraction, pulpitis, caries) | 4% articaine with epinephrine, infiltration anesthesia | 2% lidocaine with epinephrine, infiltration anesthesia | Anesthetic success rate Dental procedures; infiltration anesthesia · SCI-indexed journals | RR 1.03 [0.93, 1.15] GRADE not reported 6 studies |
| Adults (18 years or older) requiring dental procedures (extraction, pulpitis, caries) | 4% articaine with epinephrine, infiltration anesthesia | 2% lidocaine with epinephrine, infiltration anesthesia | Anesthetic success rate Dental procedures; infiltration anesthesia · Pulpitis | RR 1.05 [0.93, 1.18] GRADE not reported 10 studies |
| Adults (18 years or older) requiring dental procedures (extraction, pulpitis, caries) | 4% articaine with epinephrine, infiltration anesthesia | 2% lidocaine with epinephrine, infiltration anesthesia | Anesthetic success rate Dental procedures; infiltration anesthesia · Molar | RR 1.02 [0.94, 1.11] GRADE not reported 9 studies |
| Adults (18 years or older) requiring dental procedures (extraction, pulpitis, caries) | 4% articaine with epinephrine, infiltration anesthesia | 2% lidocaine with epinephrine, infiltration anesthesia | Pain intensity (VAS) Dental procedures; infiltration anesthesia · Premolar | MD -0.95 [-7.73, 5.84] GRADE not reported 3 studies |
| Adults (18 years or older) requiring dental procedures (extraction, pulpitis, caries) | 4% articaine with epinephrine, infiltration anesthesia | 2% lidocaine with epinephrine, infiltration anesthesia | Anesthetic success rate Dental procedures; infiltration anesthesia · Heft-Parker visual analog scale | RR 1.07 [0.93, 1.23] GRADE not reported 2 studies |
| Adults (18 years or older) requiring dental procedures (extraction, pulpitis, caries) | 4% articaine with epinephrine, infiltration anesthesia | 2% lidocaine with epinephrine, infiltration anesthesia | Anesthetic success rate Dental procedures; infiltration anesthesia · Tooth extraction | RR 1.04 [0.97, 1.12] GRADE not reported 6 studies |
| Adults (18 years or older) requiring dental procedures (extraction, pulpitis, caries) | 4% articaine with epinephrine, infiltration anesthesia | 2% lidocaine with epinephrine, infiltration anesthesia | Anesthetic duration (min) Dental procedures; infiltration anesthesia · Molar | MD 8.2 [-4.76, 21.16] GRADE not reported 3 studies |
| Adults (18 years or older) requiring dental procedures (extraction, pulpitis, caries) | 4% articaine with epinephrine, infiltration anesthesia | 2% lidocaine with epinephrine, infiltration anesthesia | Anesthetic duration (min) Dental procedures; infiltration anesthesia · Objective assessment | MD 27.34 [9.52, 45.16] GRADE not reported 4 studies |
| Adults (18 years or older) requiring dental procedures (extraction, pulpitis, caries) | 4% articaine with epinephrine, infiltration anesthesia | 2% lidocaine with epinephrine, infiltration anesthesia | Pain intensity (VAS) Dental procedures; infiltration anesthesia · Crossover experimental design | MD -2.6 [-5.07, -0.12] GRADE not reported 4 studies |
| Adults (>=18 years) requiring dental procedures (tooth extraction, caries, pulpitis) | 4% articaine with epinephrine, infiltration anesthesia | 2% lidocaine with epinephrine, infiltration anesthesia | Anesthetic onset time Dental clinics; extraction, pulpitis and endodontic pain models | MD -1.34 [-2.21, -0.47] -1.34 [-2.21, -0.47] minutes Low Downgraded: risk of bias, imprecision 7 studies · 705 participants |
| Adults (18 years or older) requiring dental procedures (extraction, pulpitis, caries) | 4% articaine with epinephrine, infiltration anesthesia | 2% lidocaine with epinephrine, infiltration anesthesia | Pain intensity (VAS) Dental procedures; infiltration anesthesia · Parallel experimental design | MD -8.72 [-16.04, -1.4] GRADE not reported 3 studies |
| Adults (18 years or older) requiring dental procedures (extraction, pulpitis, caries) | 4% articaine with epinephrine, infiltration anesthesia | 2% lidocaine with epinephrine, infiltration anesthesia | Anesthetic onset time (min) Dental procedures; infiltration anesthesia · Subjective assessment | MD -0.59 [-2.12, 0.95] GRADE not reported 4 studies |
| Adults (18 years or older) requiring dental procedures (extraction, pulpitis, caries) | 4% articaine with epinephrine, infiltration anesthesia | 2% lidocaine with epinephrine, infiltration anesthesia | Anesthetic duration (min) Dental procedures; infiltration anesthesia · Subjective assessment | MD 10.02 [-3.71, 23.74] GRADE not reported 2 studies |
| Adults (18 years or older) requiring dental procedures (extraction, pulpitis, caries) | 4% articaine with epinephrine, infiltration anesthesia | 2% lidocaine with epinephrine, infiltration anesthesia | Anesthetic onset time (min) Dental procedures; infiltration anesthesia · Objective assessment | MD -2.2 [-3.36, -1.03] GRADE not reported 3 studies |
| Adults (18 years or older) requiring dental procedures (extraction, pulpitis, caries) | 4% articaine with epinephrine, infiltration anesthesia | 2% lidocaine with epinephrine, infiltration anesthesia | Anesthetic success rate Dental procedures; infiltration anesthesia · Lidocaine with 1:100,000 epinephrine | RR 1.02 [0.98, 1.06] GRADE not reported 10 studies |
| Adults (18 years or older) requiring dental procedures (extraction, pulpitis, caries) | 4% articaine with epinephrine, infiltration anesthesia | 2% lidocaine with epinephrine, infiltration anesthesia | Anesthetic success rate Dental procedures; infiltration anesthesia · Electric pulp tester | RR 0.99 [0.9, 1.09] GRADE not reported 7 studies |
| Adults (18 years or older) requiring dental procedures (extraction, pulpitis, caries) | 4% articaine with epinephrine, infiltration anesthesia | 2% lidocaine with epinephrine, infiltration anesthesia | Anesthetic success rate Dental procedures; infiltration anesthesia · Non-SCI-indexed journals | RR 1.03 [0.96, 1.11] GRADE not reported 9 studies |
| Adults (18 years or older) requiring dental procedures (extraction, pulpitis, caries) | 4% articaine with epinephrine, nerve block anesthesia | 2% lidocaine with epinephrine, nerve block anesthesia | Anesthetic duration (min) Dental procedures; nerve block anesthesia · Non-SCI-indexed journals | MD 36.0 [24.75, 47.25] GRADE not reported 5 studies |
| Adults (18 years or older) requiring dental procedures (extraction, pulpitis, caries) | 4% articaine with epinephrine, nerve block anesthesia | 2% lidocaine with epinephrine, nerve block anesthesia | Anesthetic duration (min) Dental procedures; nerve block anesthesia · Crossover experimental design | MD 38.79 [24.83, 52.75] GRADE not reported 5 studies |
| Adults (18 years or older) requiring dental procedures (extraction, pulpitis, caries) | 4% articaine with epinephrine, nerve block anesthesia | 2% lidocaine with epinephrine, nerve block anesthesia | Anesthetic success rate Dental procedures; nerve block anesthesia · Non-SCI-indexed journals | RR 1.09 [0.82, 1.43] GRADE not reported 5 studies |
| Adults (18 years or older) requiring dental procedures (extraction, pulpitis, caries) | 4% articaine with epinephrine, nerve block anesthesia | 2% lidocaine with epinephrine, nerve block anesthesia | Anesthetic success rate Dental procedures; nerve block anesthesia · Heft-Parker visual analog scale | RR 1.05 [0.91, 1.21] GRADE not reported 6 studies |
| Adults (18 years or older) requiring dental procedures (extraction, pulpitis, caries) | 4% articaine with epinephrine, nerve block anesthesia | 2% lidocaine with epinephrine, nerve block anesthesia | Anesthetic onset time (min) Dental procedures; nerve block anesthesia · Conventional dose (1.7 or 1.8 ml) | MD -0.97 [-1.77, -0.18] GRADE not reported 5 studies |
| Adults (18 years or older) requiring dental procedures (extraction, pulpitis, caries) | 4% articaine with epinephrine, nerve block anesthesia | 2% lidocaine with epinephrine, nerve block anesthesia | Anesthetic success rate Dental procedures; nerve block anesthesia · SCI-indexed journals | RR 1.07 [0.88, 1.31] GRADE not reported 5 studies |
| Adults (18 years or older) requiring dental procedures (extraction, pulpitis, caries) | 4% articaine with epinephrine, nerve block anesthesia | 2% lidocaine with epinephrine, nerve block anesthesia | Anesthetic success rate Dental procedures; nerve block anesthesia · Lidocaine with 1:80,000 epinephrine | RR 1.0 [0.69, 1.46] GRADE not reported 3 studies |
| Adults (18 years or older) requiring dental procedures (extraction, pulpitis, caries) | 4% articaine with epinephrine, nerve block anesthesia | 2% lidocaine with epinephrine, nerve block anesthesia | Anesthetic onset time (min) Dental procedures; nerve block anesthesia · Subjective assessment | MD -0.25 [-0.39, -0.11] GRADE not reported 8 studies |
| Adults (18 years or older) requiring dental procedures (extraction, pulpitis, caries) | 4% articaine with epinephrine, nerve block anesthesia | 2% lidocaine with epinephrine, nerve block anesthesia | Anesthetic onset time (min) Dental procedures; nerve block anesthesia · High dose (> 1.8 ml) | MD -0.12 [-0.19, -0.05] GRADE not reported 3 studies |
| Adults (18 years or older) requiring dental procedures (extraction, pulpitis, caries) | 4% articaine with epinephrine, nerve block anesthesia | 2% lidocaine with epinephrine, nerve block anesthesia | Anesthetic duration (min) Dental procedures; nerve block anesthesia · High dose (> 1.8 ml) | MD 105.44 [-10.44, 221.31] GRADE not reported 2 studies |
| Adults (18 years or older) requiring dental procedures (extraction, pulpitis, caries) | 4% articaine with epinephrine, nerve block anesthesia | 2% lidocaine with epinephrine, nerve block anesthesia | Anesthetic duration (min) Dental procedures; nerve block anesthesia · Parallel experimental design | MD 74.51 [18.75, 130.27] GRADE not reported 4 studies |
| Adults (18 years or older) requiring dental procedures (extraction, pulpitis, caries) | 4% articaine with epinephrine, nerve block anesthesia | 2% lidocaine with epinephrine, nerve block anesthesia | Anesthetic onset time (min) Dental procedures; nerve block anesthesia · SCI-indexed journals | MD -0.24 [-0.39, -0.1] GRADE not reported 5 studies |
| Adults (>=18 years) requiring dental procedures (tooth extraction, caries, pulpitis) | 4% articaine with epinephrine, nerve block anesthesia | 2% lidocaine with epinephrine, nerve block anesthesia | Anesthetic onset time Dental clinics; extraction, pulpitis and endodontic pain models | MD -0.27 [-0.40, -0.13] -0.27 [-0.4, -0.13] minutes Moderate Downgraded: risk of bias 9 studies · 638 participants |
| Adults (18 years or older) requiring dental procedures (extraction, pulpitis, caries) | 4% articaine with epinephrine, nerve block anesthesia | 2% lidocaine with epinephrine, nerve block anesthesia | Anesthetic onset time (min) Dental procedures; nerve block anesthesia · Crossover experimental design | MD -0.35 [-0.57, -0.12] GRADE not reported 6 studies |
| Adults (18 years or older) requiring dental procedures (extraction, pulpitis, caries) | 4% articaine with epinephrine, nerve block anesthesia | 2% lidocaine with epinephrine, nerve block anesthesia | Anesthetic duration (min) Dental procedures; nerve block anesthesia · SCI-indexed journals | MD 75.9 [33.57, 118.23] GRADE not reported 4 studies |
| Adults (18 years or older) requiring dental procedures (extraction, pulpitis, caries) | 4% articaine with epinephrine, nerve block anesthesia | 2% lidocaine with epinephrine, nerve block anesthesia | Anesthetic success rate Dental procedures; nerve block anesthesia · Lidocaine with 1:200,000 epinephrine | RR 1.37 [0.78, 2.41] GRADE not reported 3 studies |
| Adults (18 years or older) requiring dental procedures (extraction, pulpitis, caries) | 4% articaine with epinephrine, nerve block anesthesia | 2% lidocaine with epinephrine, nerve block anesthesia | Anesthetic duration (min) Dental procedures; nerve block anesthesia · Objective assessment | MD 35.53 [17.3, 53.75] GRADE not reported 2 studies |
| Adults (>=18 years) requiring dental procedures (tooth extraction, caries, pulpitis) | 4% articaine with epinephrine, nerve block anesthesia | 2% lidocaine with epinephrine, nerve block anesthesia | Anesthetic duration Dental clinics; extraction, pulpitis and endodontic pain models | MD 53.63 [29.64, 77.62] 53.63 [29.64, 77.62] minutes High Downgraded: risk of bias 8 studies · 598 participants |
| Adults (>=18 years) requiring dental procedures (tooth extraction, caries, pulpitis) | 4% articaine with epinephrine, nerve block anesthesia | 2% lidocaine with epinephrine, nerve block anesthesia | Anesthetic success rate Dental clinics; extraction, pulpitis and endodontic pain models | RR 1.06 [0.90, 1.24] 34 [-57, 138] more per 1000 Low Downgraded: risk of bias, imprecision 9 studies · 683 participants |
| Adults (18 years or older) requiring dental procedures (extraction, pulpitis, caries) | 4% articaine with epinephrine, nerve block anesthesia | 2% lidocaine with epinephrine, nerve block anesthesia | Anesthetic onset time (min) Dental procedures; nerve block anesthesia · Parallel experimental design | MD -0.21 [-0.43, 0.01] GRADE not reported 4 studies |
| Adults (>=18 years) requiring dental procedures (tooth extraction, caries, pulpitis) | 4% articaine with epinephrine, nerve block anesthesia | 2% lidocaine with epinephrine, nerve block anesthesia | Pain intensity (VAS) Dental clinics; extraction, pulpitis and endodontic pain models | MD 1.13 [-0.49, 2.75] 1.13 [-0.49, 2.75] VAS points Moderate Downgraded: imprecision 4 studies · 318 participants |
| Adults (18 years or older) requiring dental procedures (extraction, pulpitis, caries) | 4% articaine with epinephrine, nerve block anesthesia | 2% lidocaine with epinephrine, nerve block anesthesia | Anesthetic duration (min) Dental procedures; nerve block anesthesia · Conventional dose (1.7 or 1.8 ml) | MD 41.89 [29.73, 54.04] GRADE not reported 5 studies |
| Adults (18 years or older) requiring dental procedures (extraction, pulpitis, caries) | 4% articaine with epinephrine, nerve block anesthesia | 2% lidocaine with epinephrine, nerve block anesthesia | Anesthetic onset time (min) Dental procedures; nerve block anesthesia · Non-SCI-indexed journals | MD -0.61 [-1.11, -0.1] GRADE not reported 5 studies |
| Adults (18 years or older) requiring dental procedures (extraction, pulpitis, caries) | 4% articaine with epinephrine, nerve block anesthesia | 2% lidocaine with epinephrine, nerve block anesthesia | Anesthetic success rate Dental procedures; nerve block anesthesia · Lidocaine with 1:100,000 epinephrine | RR 1.03 [0.88, 1.2] GRADE not reported 4 studies |
| Adults (18 years or older) requiring dental procedures (extraction, pulpitis, caries) | 4% articaine with epinephrine, nerve block anesthesia | 2% lidocaine with epinephrine, nerve block anesthesia | Anesthetic success rate Dental procedures; nerve block anesthesia · Double the regular dose (about 3.6 ml) | RR 1.03 [0.78, 1.35] GRADE not reported 3 studies |
| Adults (18 years or older) requiring dental procedures (extraction, pulpitis, caries) | 4% articaine with epinephrine, nerve block anesthesia | 2% lidocaine with epinephrine, nerve block anesthesia | Anesthetic onset time (min) Dental procedures; nerve block anesthesia · Objective assessment | MD -1.15 [-2.24, -0.07] GRADE not reported 2 studies |
| Adults (18 years or older) requiring dental procedures (extraction, pulpitis, caries) | 4% articaine with epinephrine, nerve block anesthesia | 2% lidocaine with epinephrine, nerve block anesthesia | Anesthetic duration (min) Dental procedures; nerve block anesthesia · Subjective assessment | MD 58.84 [27.68, 89.99] GRADE not reported 7 studies |
| Adults (18 years or older) requiring dental procedures (extraction, pulpitis, caries) | 4% articaine with epinephrine, nerve block anesthesia | 2% lidocaine with epinephrine, nerve block anesthesia | Anesthetic success rate Dental procedures; nerve block anesthesia · Conventional dose (1.7 or 1.8 ml) | RR 0.95 [0.8, 1.14] GRADE not reported 4 studies |
| Adults (18 years or older) requiring dental procedures (extraction, pulpitis, caries) | 4% articaine with epinephrine, nerve block anesthesia | 2% lidocaine with epinephrine, nerve block anesthesia | Anesthetic success rate Dental procedures; nerve block anesthesia · Electric pulp tester | RR 0.85 [0.69, 1.04] GRADE not reported 3 studies |
Included primary studies 36
Open in Studies| Study | Year | Also included by | Outcomes it informs here | Trial data |
|---|---|---|---|---|
| Aggarwal 2017 Comparative Evaluation of Anesthetic Efficacy of 2% Lidocaine, 4% Articaine, and 0.5% Bupivacaine on Inferior Alveolar Nerve Block in… PMID:28437508 | 2017 | 1 other review | Anesthetic success rate | not extracted yet |
| Hassan 2023 Comparison of Efficacy of Lidocaine and Articaine as Inferior Alveolar Nerve Blocking Agents in Patients with Symptomatic Irreversible… PMID:37893558 | 2023 | 1 other review | Anesthetic success rate | not extracted yet |
| Adigun 2022 matched by author and year (probable) | NR | this review only | Anesthetic onset time (min); Anesthetic duration (min) | not extracted yet |
| Ahmad 2014 Study of the anesthetic efficacy of inferior alveolar nerve block using articaine in irreversible pulpitis. PMID:24939268 | 2014 | this review only | Anesthetic success rate | not extracted yet |
| Al-Mahalawy 2023 Articaine versus Lidocaine in only buccal infiltration anesthesia for the extraction of mandibular anterior teeth. A prospective… PMID:37641122 | 2023 | this review only | Pain intensity (VAS) | not extracted yet |
| Allegretti 2016 Anesthetic Efficacy in Irreversible Pulpitis: A Randomized Clinical Trial. PMID:27652697 | 2016 | this review only | Anesthetic success rate | not extracted yet |
| Andrade 2019 A Randomized Control Trial Comparing Buccal Infiltration of 4% Articaine with Buccal and Palatal Infiltration of 2% Lignocaine for the… PMID:32308291 | 2019 | this review only | Anesthetic onset time (min) | not extracted yet |
| Boonsiriseth 2017 4% lidocaine versus 4% articaine for inferior alveolar nerve block in impacted lower third molar surgery. PMID:28879326 | 2017 | this review only | Anesthetic onset time (min); Anesthetic duration (min); Pain intensity (VAS) | not extracted yet |
| Claffey 2004 Anesthetic efficacy of articaine for inferior alveolar nerve blocks in patients with irreversible pulpitis. PMID:15273637 | 2004 | this review only | Anesthetic success rate | not extracted yet |
| de Souza Santos 2024 Efficacy of analgesia promoted by lidocaine and articaine in third molar extraction surgery. A split-mouth, randomized, controlled trial. PMID:38355872 | 2024 | this review only | Anesthetic onset time (min); Anesthetic duration (min); Pain intensity (VAS) | not extracted yet |
| Deshpande 2020 Anesthetic efficacy and safety of 2% lidocaine hydrochloride with 1:100,000 adrenaline and 4% articaine hydrochloride with 1:100,000… PMID:32934989 | 2020 | this review only | Anesthetic onset time (min); Anesthetic duration (min); Anesthetic success rate | not extracted yet |
| Hassan 2011 Efficacy of 4% articaine hydrochloride and 2% lignocaine hydrochloride in the extraction of maxillary premolars for orthodontic reasons. PMID:23482319 | 2011 | this review only | Anesthetic onset time (min); Anesthetic duration (min); Pain intensity (VAS) | not extracted yet |
| Hosseini 2016 Efficacy of Articaine and Lidocaine for Buccal Infiltration of First Maxillary Molars with Symptomatic Irreversible Pulpitis: A Randomized… PMID:27141212 | 2016 | this review only | Anesthetic success rate | not extracted yet |
| Jaiswal 2023 A Split-Mouth Clinical Comparative Evaluation of the Anesthetic Efficacy of Articaine and Lignocaine for Maxillary Bicuspids Extraction. PMID:37431340 | 2023 | this review only | Anesthetic onset time (min); Anesthetic duration (min) | not extracted yet |
| Kanaa 2012 A comparison of the efficacy of 4% articaine with 1:100,000 epinephrine and 2% lidocaine with 1:80,000 epinephrine in achieving pulpal… PMID:22341059 | 2012 | this review only | Anesthetic onset time (min); Pain intensity (VAS); Anesthetic success rate | not extracted yet |
| Kolay 2025 Comparison of the effects of lidocaine and articaine used for buccal infiltration and supplemental palatinal infiltration anesthesia in… PMID:39923048 | 2025 | this review only | Anesthetic success rate | not extracted yet |
| Krishna 2023 Comparison of the Efficacy Between Articaine and Lignocaine in Simultaneous Bilateral Orthodontic Maxillary Premolar Extractions: A… PMID:38192927 | 2023 | this review only | Anesthetic duration (min) | not extracted yet |
| Kumar 2024 Buccal versus buccal palatal infiltration for pulpal anesthesia using 2% lidocaine and 4% articaine: A randomized controlled trial. PMID:38445050 | 2024 | this review only | Anesthetic success rate | not extracted yet |
| Majid 2018 The Anesthetic Efficacy of Articaine and Lidocaine in Equivalent Doses as Buccal and Non-Palatal Infiltration for Maxillary Molar… PMID:29257943 | 2018 | this review only | Pain intensity (VAS); Anesthetic success rate | not extracted yet |
| Phyo 2020 Single buccal infiltration of high concentration lignocaine versus articaine in maxillary third molar surgery. PMID:32934986 | 2020 | this review only | Pain intensity (VAS); Anesthetic success rate | not extracted yet |
| Poorni 2011 Anesthetic efficacy of four percent articaine for pulpal anesthesia by using inferior alveolar nerve block and buccal infiltration… PMID:22099890 | 2011 | this review only | Anesthetic success rate | not extracted yet |
| Saralaya 2018 4% Articaine and 2% Lignocaine for Surgical Removal of Third Molar by Mandibular Nerve Block: A Randomized Clinical Trial for Efficacy and… PMID:31371883 | 2019 | this review only | Anesthetic onset time (min); Anesthetic duration (min); Anesthetic success rate | not extracted yet |
| Sayphiboun 2020 The anesthetic efficiency of retromolar infiltrations with two local anesthetic solutions of the same concentration in lower third molar… PMID:32617408 | 2020 | this review only | Anesthetic onset time (min); Anesthetic duration (min); Pain intensity (VAS); Anesthetic success rate | not extracted yet |
| Selvam 2024 Revolutionising Third Molar Surgery: Unveiling the Superiority of Articaine and Lignocaine in Nerve Block Techniques. A Ground-breaking… PMID:39902435 | 2025 | this review only | Anesthetic onset time (min); Anesthetic duration (min) | not extracted yet |
| Sharma 2019 Anesthetic Efficacy of Single Buccal Infiltration of 4% Articaine and 2% Lignocaine in Extraction of Maxillary 1st Molar. PMID:31909001 | 2019 | this review only | Anesthetic duration (min) | not extracted yet |
| Sherman 2008 Anesthetic efficacy of the Gow-Gates injection and maxillary infiltration with articaine and lidocaine for irreversible pulpitis. PMID:18498883 | 2008 | this review only | Anesthetic success rate | not extracted yet |
| Shruthi 2013 Articaine for surgical removal of impacted third molar; a comparison with lignocaine. PMID:24155578 | 2013 | this review only | Anesthetic onset time (min); Anesthetic duration (min) | not extracted yet |
| Sierra Rebolledo 2007 Comparative study of the anesthetic efficacy of 4% articaine versus 2% lidocaine in inferior alveolar nerve block during surgical… PMID:17322803 | 2007 | this review only | Anesthetic onset time (min); Anesthetic duration (min); Pain intensity (VAS) | not extracted yet |
| Silva 2012 Articaine versus lidocaine for third molar surgery: a randomized clinical study. PMID:22157664 | 2012 | this review only | Anesthetic onset time (min) | not extracted yet |
| Sood 2014 Comparison of anesthetic efficacy of 4% articaine with 1:100,000 epinephrine and 2% lidocaine with 1:80,000 epinephrine for inferior… PMID:25674319 | 2014 | this review only | Anesthetic success rate | not extracted yet |
| Srinivasan 2009 Comparison of anesthetic efficacy of 4% articaine and 2% lidocaine for maxillary buccal infiltration in patients with irreversible pulpitis. PMID:19101495 | 2009 | this review only | Pain intensity (VAS); Anesthetic success rate | not extracted yet |
| Srisurang 2010 Clinical efficacy of lidocaine, mepivacaine, and articaine for local infiltration. PMID:25427324 | 2011 | this review only | Anesthetic success rate | not extracted yet |
| Syed 2022 Comparative Evaluation of Anesthetic Efficacy of 4% Articaine and 2% Lidocaine for Buccal Infiltration in Adult Patients with Irreversible… PMID:35466294 | 2022 | this review only | Anesthetic success rate | not extracted yet |
| Tortamano 2009 A comparison of the anesthetic efficacy of articaine and lidocaine in patients with irreversible pulpitis. PMID:19166765 | 2009 | this review only | Anesthetic success rate | not extracted yet |
| Tortamano 2013 Onset and duration period of pulpal anesthesia of articaine and lidocaine in inferior alveolar nerve block. PMID:24173259 | 2013 | this review only | Anesthetic onset time (min); Anesthetic duration (min) | not extracted yet |
| Vishal 2021 Comparative study of the anaesthetic efficacy of 4% articaine versus 2% lidocaine with adrenaline during extraction of mandibular molars… PMID:34301445 | 2021 | this review only | Anesthetic onset time (min); Anesthetic duration (min); Pain intensity (VAS) | not extracted yet |
Overlap with other reviews
Reviews that include the same primary studies are not independent evidence. Shared counts match studies by PMID, DOI or NCT, and otherwise by author and year (a probable match). Only the non-Cochrane dental reviews have study lists, so overlap with Cochrane reviews is not counted yet.
Review question
| Element | Planned (methods) | Found (results) |
|---|---|---|
| Population | Adults (>=18 years) requiring dental procedures with clinical indications (e.g., tooth extraction, dental caries, pulpitis) | Adults undergoing dental procedures (extraction, pulpitis, caries); infiltration 1,862 cases (19 RCTs), nerve block 1,226 cases (17 RCTs) |
| Intervention | Articaine with epinephrine by infiltration or nerve block anesthesia | 4% articaine with epinephrine (1:100,000 in 35 studies, 1:200,000 in 1) |
| Comparison | Lidocaine with epinephrine by infiltration or nerve block anesthesia | 2% lidocaine with epinephrine (1:80,000 n=6; 1:100,000 n=29; 1:200,000 n=3); 4% lidocaine in 3 studies |
| Outcomes | Anesthetic onset time; anesthetic duration; pain intensity (VAS); anesthetic success rate | Onset time (7 and 9 studies); duration (7 and 8); VAS pain (7 and 4); success (12 and 9) for infiltration and nerve block respectively |
| Study designs | RCTs (parallel and crossover) | 36 RCTs (n=3,088) published 2004-2025 |
| Timing | Not specified | Not specified |
AMSTAR 2 items
Two independent extractors rated each item. Their ratings are shown side by side because they have not been reconciled yet. The overall rating follows Shea et al. 2017: one critical flaw gives Low, more than one gives Critically Low.
| Item | Extractor A | Extractor B | Agree |
|---|---|---|---|
| 1Research question includes PICO components | Yes | Yes | yes |
| 2Protocol established before the reviewcritical | Partial Yes | Partial Yes | yes |
| 3Choice of study designs explained | No | No | yes |
| 4Comprehensive literature searchcritical | Partial Yes | Partial Yes | yes |
| 5Study selection in duplicate | Yes | Yes | yes |
| 6Data extraction in duplicate | No | No | yes |
| 7List of excluded studies with reasonscritical | No | No | yes |
| 8Included studies described in detail | Partial Yes | Partial Yes | yes |
| 9Risk of bias assessed satisfactorilycritical | RCT: Yes · NRSI: N/A | NRSI: N/A · RCT: Yes | no |
| 10Funding of included studies reported | No | No | yes |
| 11Appropriate meta-analysis methodscritical | RCT: Yes · NRSI: N/A | NRSI: N/A · RCT: Yes | no |
| 12Impact of risk of bias on the pooled results | No | No | yes |
| 13Risk of bias accounted for in interpretationcritical | Yes | Yes | yes |
| 14Heterogeneity explained | Yes | Yes | yes |
| 15Publication bias investigatedcritical | Yes | Yes | yes |
| 16Conflicts of interest reported | Yes | Yes | yes |
| Overall | Low | Low | yes |