Comparison of the anesthetic effect of bupivacaine and articaine in third molar extractions: a split-mouth randomized controlled trialAbstract
Introduction The extraction of third molars is one of the most frequently performed surgical procedures in dentistry and requires effective anesthesia for adequate pain control. Among the local anesthetics used, articaine and bupivacaine stand out for their differences in onset of action, duration, and analgesic profile. Comparing these agents may contribute to selecting the most appropriate protocol for oral surgeries.
Objective This split-mouth randomized controlled trial aimed to compare the anesthetic effectiveness of Bupivacaine and Articaine in third molar extraction.
Material and method Thirty-two patients underwent extraction of all four third molars after approval by the Research Ethics Committee of the Federal University of Uberlândia. Each patient received two different anesthetic agents: one side with Bupivacaine 0.5% plus epinephrine (1:200,000) and the other with 4% Articaine plus epinephrine (1:100,000). Anesthesia was administered using three cartridges per hemi-arch to achieve analgesia in both upper and lower third molars. Variables analyzed included the need for anesthetic supplementation, onset and duration of anesthesia, and pain intensity assessed with the Visual Analog Scale (VAS) during and after surgery.
Result Articaine showed a significantly faster onset and shorter duration of anesthesia compared to Bupivacaine (p < 0.05). Despite this, the number of supplementary anesthetic cartridges required was similar for both groups. Patients reported significantly higher postoperative pain on the side anesthetized with Bupivacaine (p < 0.05).
Conclusion In conclusion, Articaine provides quicker onset and better intraoperative pain control, while Bupivacaine offers a prolonged postoperative anesthetic effect.
Descriptors:
Anesthesia; pain management; third molar; bupivacaine; articaine
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