alexa Articaine (4%) Buccal Infiltration versus Lidocaine (2%) Inferior Alveolar Nerve Block for Mandibular Teeth Extraction in Patients on Warfarin Treatment
ISSN: 2155-6148

Journal of Anesthesia & Clinical Research
Open Access

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Research Article

Articaine (4%) Buccal Infiltration versus Lidocaine (2%) Inferior Alveolar Nerve Block for Mandibular Teeth Extraction in Patients on Warfarin Treatment

Walid Ahmed Abdullah1,2, Hesham Khalil1* and Saad Sheta1,3

1Department of Oral and Maxillofacial Surgery, College of Dentistry, King Saud University, Riyadh, Saudi Arabia

2Department of Oral and Maxillofacial Surgery, College of Dentistry, Mansoura University, Mansoura, Egypt

3College of Medicine, Alexandria University, Alexandria, Egypt

*Corresponding Author:
Dr.Hesham S Khalil
College of Dentistry, King Saud University
Riyadh, Saud Arabia
Tel: 96611 467 7414
E-mail: [email protected]

Received date: July 15, 2014; Accepted date: August 21, 2014; Published date: August 28, 2014

Citation: Abdullah WA, Khalil H, Sheta S (2014) Articaine (4%) Buccal Infiltration versus Lidocaine (2%) Inferior Alveolar Nerve Block for Mandibular Teeth Extraction in Patients on Warfarin Treatment. J Anesth Clin Res 5:434. doi: 10.4172/2155-6148.1000434

Copyright: © 2014 Abdullah WA, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.



Background: Although lidocaine inferior alveolar nerve block is a common dental injection in case of managing mandibular teeth, it may not be the first choice in specific situations. Patients on warfarin therapy are at high risk of bleeding during dental procedures. In this study we aimed to investigate and compare the efficacy of articaine buccal infiltration in mandibular teeth extraction with lidocaine inferior alveolar nerve block for extraction of mandibular teeth in patients on warfarin treatment.

Methods: Patients included in the present study were on warfarin treatment and referred for simple dental extraction. Patients were divided randomly in two groups, one group received standard inferior alveolar nerve block (1.8 ml of 2% lidocaine with 1:80,000 adrenaline) and the second group received buccal infiltration supported with lingual infiltration using 4% articaine and 1:100,000 adrenaline. Data was analyzed by descriptive analysis using SPSS program V.17. A Mann-Whitney U test to compare the results and p value of less than 0.05 was considered significant.

Results: A total of 23 adult patients (10 women and 13 men) aged 40 to 57 years (mean=48.9) were recruited into the study with 6 excluded as they needed a second local anesthetic cartridge to obtain profound anesthesia. The success rate of inferior alveolar nerve block using lidocaine was 81.8% while the success rate for articaine buccal infiltration in obtaining good profound pulpal anesthesia was 66.6%. Both surgeons and patients were satisfied with anesthesia using both drugs.

Conclusion: Buccal infiltration of 4% Articaine for mandibular teeth can have a high success rate using one local anesthetic cartridge, and is considered a good alternative option for nerve block in patients on warfarin treatment to avoid complication related to the nerve block.


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