Non-Cochrane · other · PM42889444
Articaine versus lidocaine for local anesthesia in pediatric dental procedures: an umbrella review of systematic reviews and meta-analyses.
Yao Yun-Xi, Huang Shuo, Liu Ke-Xin, et al. · Journal of dental anesthesia and pain medicine · 2026 · PubMed · doi:10.17245/jdapm.2026.26.128
Findings
18 findings
| Population | ||||
|---|---|---|---|---|
| Children undergoing dental procedures | Articaine | Lidocaine | Self-reported pain during treatment | SMD 0.06 Very low Downgraded: risk of bias, imprecision, inconsistency Studies not reported |
| Children and adolescents undergoing dental procedures | Articaine local anesthesia | Lidocaine (lignocaine) local anesthesia | Postoperative (postprocedural) pain Postoperative · Pediatric dentistry · Source review: Li 2023 | Li et al.: no significant differences in postoperative pain (estimate not reported in umbrella review) Very low Downgraded: risk of bias, imprecision, inconsistency Studies not reported |
| Children undergoing dental procedures | Articaine | Lidocaine | Edema | RR 1.78 [0.17, 18.81] Very low Downgraded: risk of bias, imprecision, inconsistency, indirectness Studies not reported |
| Children undergoing dental procedures | Articaine | Lidocaine | Overall adverse events | RR 1.10 Low Downgraded: risk of bias, imprecision Studies not reported |
| Children undergoing dental procedures | Articaine | Lidocaine | Soft-tissue injury | RR 0.47 [0.17, 1.28] Very low Downgraded: risk of bias, imprecision, indirectness Studies not reported |
| Children and adolescents undergoing dental procedures | Articaine local anesthesia | Lidocaine (lignocaine) local anesthesia | Anesthetic success / supplemental anesthesia Pediatric dentistry · Outcome-domain GRADE assessment | Very low (one plus sign): Evidence is insufficient for firm conclusions. Very low Downgraded: risk of bias, imprecision, inconsistency Studies not reported |
| Children undergoing dental procedures | Articaine | Lidocaine | Postoperative pain | RR 1.68 [0.56, 5.08] Very low Downgraded: risk of bias, imprecision, inconsistency Studies not reported |
| Children undergoing dental procedures | Articaine | Lidocaine | Soft-tissue injury | no estimate extracted Very low Downgraded: risk of bias, imprecision, indirectness Studies not reported |
| Children undergoing dental procedures | Articaine | Lidocaine | Postprocedural pain | SMD 0.37 Very low Downgraded: risk of bias, imprecision, inconsistency Studies not reported |
| Children and adolescents undergoing dental procedures | Articaine local anesthesia | Lidocaine (lignocaine) local anesthesia | Edema / uncommon adverse events Pediatric dentistry · Source review: Li 2023 | Li et al.: no significant differences in edema (estimate not reported in umbrella review) Very low Downgraded: risk of bias, imprecision, inconsistency, indirectness Studies not reported |
| Children undergoing dental procedures | Articaine | Lidocaine | Facial Pain Scale effectiveness | MD -0.46 [-0.81, -0.12] Very low Downgraded: risk of bias, imprecision, inconsistency Studies not reported |
| Children undergoing dental procedures | Articaine | Lidocaine | Overall adverse reactions | RR 1.08 [0.54, 2.15] Low Downgraded: risk of bias, imprecision Studies not reported |
| Children undergoing dental procedures | Articaine | Lidocaine | Overall adverse events | RR 1.26 [0.62, 2.54] Low Downgraded: risk of bias, imprecision Studies not reported |
| Children undergoing dental procedures | Articaine | Lidocaine | Visual Analog Scale effectiveness | MD -0.20 [-0.29, -0.10] Very low Downgraded: risk of bias, imprecision, inconsistency Studies not reported |
| Children undergoing primary molar extraction | Articaine buccal infiltration | Lidocaine buccal infiltration | Pain during primary molar extraction | no estimate extracted Very low Downgraded: risk of bias, imprecision, inconsistency, indirectness Studies not reported |
| Children undergoing mandibular molar treatment or pulp therapy | Articaine buccal infiltration | Lidocaine (lignocaine) inferior alveolar nerve block | Pain during treatment During treatment · Pediatric dentistry, mandibular molar treatment/pulp therapy · Source review: Yu 2021 | Yu et al.: no significant difference in treatment pain Very low Downgraded: risk of bias, imprecision, inconsistency, indirectness Studies not reported |
| Children undergoing mandibular molar treatment | Articaine buccal infiltration | Lidocaine inferior alveolar nerve block | Anesthetic success Unresolved: the two extractors disagree on this row. | OR 1.02 [0.13, 7.96] Very low Downgraded: risk of bias, imprecision, inconsistency Studies not reported |
| Children undergoing primary mandibular molar pulp therapy | 4% articaine buccal infiltration | 2% lidocaine inferior alveolar nerve block | Pulpal anesthesia during pulp therapy | no estimate extracted Very low Downgraded: risk of bias, imprecision, inconsistency, indirectness Studies not reported |
Included primary studies 21
Open in Studies| Study | Year | Also included by | Outcomes it informs here | Trial data |
|---|---|---|---|---|
| Afsal 2019 Pain perception and efficacy of local analgesia using 2% lignocaine, buffered lignocaine, and 4% articaine in pediatric dental procedures DOI:10.17245/jdapm.2019.19.2.101 | 2019 | 1 other review | not stated | not extracted yet |
| Malamed 2000 A comparison between articaine HCl and lidocaine HCl in pediatric dental patients. PMID:10969438 | 2000 | 1 other review | not stated | not extracted yet |
| Alinejhad 2018 Comparison of Visual Analog Scale Scores in Pain Assessment during Pulpotomy using Different Injection Materials in Children Aged 6 to 8… DOI:10.5005/jp-journals-10024-2259 | 2018 | this review only | not stated | not extracted yet |
| Alzahrani 2018 Anaesthetic efficacy of 4% articaine and 2% lidocaine for extraction and pulpotomy of mandibular primary molars: an equivalence parallel… DOI:10.1111/ipd.12361 | 2018 | this review only | not stated | not extracted yet |
| Arali 2015 Anaesthetic efficacy of 4% articaine mandibular buccal infiltration compared to 2% lignocaine inferior alveolar nerve block in children… PMID:26023647 | 2015 | this review only | not stated | not extracted yet |
| Arrow 2012 A comparison of articaine 4% and lignocaine 2% in block and infiltration analgesia in children DOI:10.1111/j.1834-7819.2012.01699.x | 2012 | this review only | not stated | not extracted yet |
| Chenchugopal 2017 In vivo Evaluation of 4% Articaine and 2% Lignocaine Intraligamentary Injection Administered with Single Tooth Anesthesia-Wand. PMID:28839421 | 2017 | this review only | not stated | not extracted yet |
| Chopra 2016 Evaluation of Buccal Infiltration with Articaine and Inferior Alveolar Nerve Block with Lignocaine for Pulp Therapy in Mandibular Primary… DOI:10.17796/1053-4628-40.4.301 | 2016 | this review only | not stated | not extracted yet |
| Elheeny 2020 Articaine efficacy and safety in young children below the age of four years: An equivalent parallel randomized control trial DOI:10.1111/ipd.12640 | 2020 | this review only | not stated | not extracted yet |
| Ghadimi 2018 The efficacy of articaine infiltration versus lidocaine inferior alveolar nerve block for pulpotomy in mandibular primary second molars:… DOI:10.15171/joddd.2018.015 | 2018 | this review only | not stated | not extracted yet |
| Jaikaria 2017 Comparative evaluation of the efficacy of 4% articaine and 2% lidocaine in children during the primary maxillary molar extractions DOI:10.4103/ijohr.ijohr_36_17 | 2017 | this review only | not stated | not extracted yet |
| Jain 2021 Comparative evaluation of anesthetic efficacy of 4% articaine infiltration versus 2% lignocaine inferior alveolar nerve block for… DOI:10.4103/jisppd.jisppd_260_21 | 2021 | this review only | not stated | not extracted yet |
| Jorgenson 2019 Comparison of the efficacy of a standard inferior alveolar nerve block versus articaine infiltration for invasive dental treatment in… DOI:10.1007/s40368-019-00496-8 | 2019 | this review only | not stated | not extracted yet |
| Khanna 2021 DOI:10.3290/j.qi.b1492247 | NR | this review only | not stated | not extracted yet |
| Kolli 2017 The Effectiveness of Articaine and Lidocaine Single Buccal Infiltration versus Conventional Buccal and Palatal Injection Using Lidocaine… PMID:28298777 | 2017 | this review only | not stated | not extracted yet |
| Malamed 2000 matched by author and year (probable) | NR | this review only | not stated | not extracted yet |
| Massignan 2020 Efficacy and adverse events of 4% articaine compared with 2% lidocaine on primary molar extraction: A randomised controlled trial DOI:10.1111/joor.12989 | 2020 | this review only | not stated | not extracted yet |
| Mittal 2015 matched by author and year (probable) | NR | this review only | not stated | not extracted yet |
| Nair 2018 COMPARING THE EFFICIENCY OF 2% LIDOCAINE AND 4% ARTICAINE AS A LOCAL ANESTHETIC AGENT IN CHILDREN DOI:10.22159/ajpcr.2018.v11i5.24440 | 2018 | this review only | not stated | not extracted yet |
| Ram 2006 Comparison of articaine 4% and lidocaine 2% in paediatric dental patients DOI:10.1111/j.1365-263x.2006.00745.x | 2006 | this review only | not stated | not extracted yet |
| Rathi 2019 Anesthetic Efficacy of Buccal Infiltration Articaine versus Lidocaine for Extraction of Primary Molar Teeth DOI:10.2344/anpr-65-04-02 | 2019 | this review only | not stated | 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 | Children or adolescents undergoing dental procedures (mixed-age reviews only if pediatric evidence separable) | Children/adolescents in dental procedures (n=8 SRMAs; 21 unique primary studies, 55 occurrences) |
| Intervention | Articaine local anesthesia | Articaine, including articaine buccal infiltration (n=8 SRMAs) |
| Comparison | Lidocaine local anesthesia (direct comparison) | Lidocaine/lignocaine, including lidocaine infiltration and IANB (n=8 SRMAs) |
| Outcomes | Overall anesthetic effectiveness and procedural pain; injection-related pain; postoperative pain; primary molar extraction; mandibular molar treatment and pulp therapy; anesthetic success or supplemental anesthesia; overall adverse events; soft tissue injury; edema; uncommon adverse events; clinical applicability | Anesthetic effectiveness/procedural pain (GRADE very low); pain during treatment (very low); postoperative pain (very low); primary molar extraction (very low); mandibular molar pulp therapy (very low); anesthetic success/supplemental anesthesia (very low); overall adverse events (low); soft-tissue injury (very low); edema/uncommon adverse events (very low) |
| Study designs | Systematic reviews with or without meta-analysis (umbrella review) | Systematic reviews with meta-analysis (n=6) and systematic reviews without meta-analysis (n=2), each including 5 to 11 RCTs |
| Timing | Not specified | Not specified |