Primary study · included by 1 review

Efficacy of Articaine versus Lidocaine in Supplemental Infiltration for Mandibular First versus Second Molars with Irreversible Pulpitis: A Prospective, Randomized, Double-blind Clinical Trial

Shapiro 2018 · Shapiro Michael R., McDonald Neville J., Gardner Richard J., et al. · Journal of Endodontics · 2018

Included by

Evaluation of the effectiveness of local anesthesia approaches for symptomatic irreversible pulpitis: a systematic review and meta-analysis.

Non-Cochrane · intervention · 2025 · cited as Shapiro 2018 · Table 1; Figure 3

Outcome this study informs	Pooled effect	Evidence	Certainty
Anesthesia success (adequate pain control during endodontic treatment) Modified anesthetic protocols (articaine, supplemental infiltrations, additives, increased volume) vs Conventional inferior alveolar nerve block (IANB) with 2% lidocaine with epinephrine · During endodontic treatment	OR 3.62 [2.91, 4.27]	3 studies	GRADE not reported
Anesthesia success (adequate pain control during endodontic treatment) Modified anesthetic protocols (articaine, supplemental infiltrations, additives, increased volume) vs Conventional inferior alveolar nerve block (IANB) with 2% lidocaine with epinephrine · During endodontic treatment	OR 3.34 [2.49, 4.48]	16 studies	High
Anesthesia success (adequate pain control during endodontic treatment) Modified anesthetic protocols (articaine, supplemental infiltrations, additives, increased volume) vs Conventional inferior alveolar nerve block (IANB) with 2% lidocaine with epinephrine · During endodontic treatment	OR 3.26 [1.70, 6.28]	3 studies	GRADE not reported
Anesthesia success (adequate pain control during endodontic treatment) Modified anesthetic protocols (articaine, supplemental infiltrations, additives, increased volume) vs Conventional inferior alveolar nerve block (IANB) with 2% lidocaine with epinephrine · During endodontic treatment	OR 3.36 [1.44, 7.85]	3 studies	GRADE not reported
Anesthesia success (adequate pain control during endodontic treatment) Modified anesthetic protocols (articaine, supplemental infiltrations, additives, increased volume) vs Conventional inferior alveolar nerve block (IANB) with 2% lidocaine with epinephrine · During endodontic treatment	OR 4.31 [3.59, 5.17]	6 studies	High
Anesthesia success (adequate pain control during endodontic treatment) Modified anesthetic protocols (articaine, supplemental infiltrations, additives, increased volume) vs Conventional inferior alveolar nerve block (IANB) with 2% lidocaine with epinephrine · During endodontic treatment	OR 3.79 [3.24, 4.44]	16 studies	GRADE not reported

1 including review in total.