Suhui Qian,1,* Ziying Meng,2,* Haiyan Zhang,1 Kaicheng Li,1 Fei Zhang,1 Sen Zhang,1 Jianfei Liu,1 Zhou Zhou1 

1Department of Stomatology, Huaibei People’s Hospital, Huaibei, Anhui, People’s Republic of China; 2Stomatology Department of Suixi County Hospital, Huaibei, Anhui, People’s Republic of China

*These authors contributed equally to this work

Correspondence: Zhou Zhou, Email Zz178685@163.com

Objective: This study aimed to compare the anesthetic efficacy of articaine needle-free anesthesia with conventional lidocaine nerve block anesthesia for root canal treatment in permanent teeth with irreversible pulpitis.
Methods: In this prospective clinical trial, 94 patients were randomly allocated to receive either articaine needle-free anesthesia (n=47) or lidocaine nerve block anesthesia (n=47). Anesthetic effectiveness was evaluated through onset time, success rate, and visual analog scale (VAS) pain scores during crown opening and pulp removal procedures. Secondary outcomes included hemodynamic stability (heart rate, systolic and diastolic blood pressure) and incidence of adverse reactions.
Results: The articaine group exhibited significantly faster anesthesia onset (7.62± 1.28 minutes vs 9.35± 2.04 minutes, p< 0.05) and higher success rate (93.62% vs 80.85%, p< 0.05). Patients receiving articaine reported significantly lower pain scores during crown opening (4.31± 1.13 vs 5.48± 1.06) and pulp removal (3.18± 1.07 vs 4.26± 1.12) (both p< 0.05). Both groups maintained comparable hemodynamic stability throughout the procedure (p> 0.05), with no significant difference in adverse reaction rates (11.49% vs 10.64%, p> 0.05).
Conclusion: Articaine needle-free anesthesia demonstrates superior clinical performance compared to conventional lidocaine nerve block, offering faster onset, improved success rate, and enhanced pain control during root canal treatment of irreversible pulpitis, while maintaining equivalent safety parameters. These findings support its adoption as an effective alternative for dental anesthesia in endodontic procedures.

Keywords: articaine needle-free anesthesia, conventional anesthesia, irreversible pulpitis, root canal treatment, effects, pain, impact