Natural Sciences, Stomotology, 2026
ISSN: 1829-006X
COMPARING THE LOCAL ANAESTHETIC EFFICACY DURING THE EXTRACTION OF IMPACTED MANDIBULAR 3RD MOLARS IN POPULATION OF JIZAN PROVINCE OF SAUDI ARABIA- A RANDOMISED PROSPECTIVE STUDY”
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Submitted: 2026-04-08
© 2026 by author(s) and The Gufo Inc.
This work is licensed under Creative Commons Attribution–NonCommercial International License
(CC BY-NC 4.0).
Abstract
Aim:To compare the local anesthetic efficacy of 2% lidocaine, 2% mepivacaine, and 4% articaine with 1:100,000
epinephrine during the surgical extraction of impacted mandibular third molars in the Jizan population of Saudi
Arabia.
Materials and Methods:This randomized prospective clinical study included 180 ASA-I patients aged 20–40 years
requiring surgical removal of impacted mandibular third molars. Patients were randomly allocated into three groups
(n = 60 each): Group A received 2% lidocaine, Group B received 2% mepivacaine, and Group C received 4%
articaine, all with 1:100,000 epinephrine. Onset and duration of anesthesia, reinjection requirement, surgical time,
hemodynamic changes, return of sensation, and postoperative pain (VAS at 24 hours) were assessed. Data were
analyzed using ANOVA with p < 0.05 considered statistically significant.
Results:Articaine showed the fastest onset of anesthesia (1.9 ± 0.4 min) compared to mepivacaine (3.1 ± 0.6 min)
and lidocaine (3.5 ± 0.8 min; p < 0.001). The duration of anesthesia was significantly longer with articaine (245 ± 12
min) than mepivacaine (185 ± 15 min) and lidocaine (172 ± 14 min; p < 0.001). Reinjection was least required with
articaine (4%) compared to mepivacaine (10%) and lidocaine (18%). Surgical time was shortest in the articaine
group (18.6 ± 2.3 min; p < 0.05). Postoperative pain scores were lowest with articaine (2.1 ± 0.9) compared to
mepivacaine (3.9 ± 1.1) and lidocaine (4.5 ± 1.2; p < 0.001). Hemodynamic variations were minimal and not
statistically significant between groups.
Conclusion:Articaine provided faster onset, longer duration, superior anesthetic reliability, and lower postoperative
pain compared to lidocaine and mepivacaine, without significant hemodynamic risks. It can be considered the
anesthetic of choice for surgical removal of impacted mandibular third molars.