D’Souza OK. Comparative evaluation of anesthetic efficacy of articaine vs lignocaine during root canal therapy in hypomineralized second primary molars. World J Clin Cases 2026; 14(10): 118053 [DOI: 10.12998/wjcc.v14.i10.118053]
Corresponding Author of This Article
Olando Kevin D'Souza, Consultant, Department of Pedodontics and Preventive Dentistry, Goa Dental College and Hospital, Near Goa Medical College, Bambolim 403202, Goa, India. olandokevindsouza@gmail.com
Research Domain of This Article
Pediatrics
Article-Type of This Article
Randomized Controlled Trial
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This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Apr 6, 2026 (publication date) through Apr 5, 2026
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Journal Information of This Article
Publication Name
World Journal of Clinical Cases
ISSN
2307-8960
Publisher of This Article
Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA
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D’Souza OK. Comparative evaluation of anesthetic efficacy of articaine vs lignocaine during root canal therapy in hypomineralized second primary molars. World J Clin Cases 2026; 14(10): 118053 [DOI: 10.12998/wjcc.v14.i10.118053]
Comparative evaluation of anesthetic efficacy of articaine vs lignocaine during root canal therapy in hypomineralized second primary molars
Olando Kevin D’Souza
Olando Kevin D’Souza, Department of Pedodontics and Preventive Dentistry, Goa Dental College and Hospital, Bambolim 403202, Goa, India
Author contributions: D’Souza OK conceptualized and designed the study, collected data, and carried out the initial analyses and manuscript writing.
Institutional review board statement: Ethical approval was obtained from the Institutional Ethics Committee of Goa Dental College and Hospital (No. GDCH/IRB/V-2025/RPN29-29).
Clinical trial registration statement: The manuscript has been registered at https://www.ctri.nic.in/, No. CTRI/2025/08/092581.
Informed consent statement: All participants provided informed consent.
Conflict-of-interest statement: All authors declare no conflict of interest in publishing the manuscript.
CONSORT 2010 statement: The authors have read the CONSORT 2010 Statement, and the manuscript was prepared and revised according to the CONSORT 2010 Statement.
Data sharing statement: Deidentified individual participant data (including data dictionaries), along with the study protocol, statistical analysis plan, and informed consent form, will be made available upon publication. Data access will be granted to researchers who submit a methodologically sound proposal aligned with the objectives of the approved study. Proposals should be submitted to olandokevindsouza@gmail.com.
Corresponding author: Olando Kevin D'Souza, Consultant, Department of Pedodontics and Preventive Dentistry, Goa Dental College and Hospital, Near Goa Medical College, Bambolim 403202, Goa, India. olandokevindsouza@gmail.com
Received: December 23, 2025 Revised: February 10, 2026 Accepted: March 6, 2026 Published online: April 6, 2026 Processing time: 100 Days and 23.3 Hours
Abstract
BACKGROUND
Achieving reliable pulpal anesthesia during root canal treatment of hypomineralized second primary molars (HSPM) is clinically challenging, as structural alterations in enamel and dentin can impair the performance of conventional local anesthetic agents. Although 2% lignocaine remains the standard anesthetic in pediatric dentistry, its efficacy may be diminished in hypomineralized teeth. In contrast, 4% articaine, characterized by higher lipid solubility and superior hard-tissue penetration, has been proposed as a more effective option for attaining profound pulpal anesthesia in such cases.
AIM
To evaluate the anesthetic efficacy of 4% articaine vs 2% lignocaine, when administered as an inferior alveolar nerve block for root canal therapy of HSPM.
METHODS
The study comprised 20 pediatric participants, each undergoing two treatment sessions. At the initial appointment, children were randomized to receive either 4% articaine or 2% lignocaine, with the alternate anesthetic administered in the second session as part of the split-mouth design. Injection discomfort and anesthetic effectiveness were systematically evaluated using the Wong-Baker Faces Pain Rating Scale (WBFPRS) and the Face, Legs, Activity, Cry, and Consolability (FLACC) scale. Data were entered into a Microsoft Excel spreadsheet and subsequently analyzed using the IBM SPSS version 26.0 software.
RESULTS
The participants had a mean age of 7.15 ± 0.67 years. Pain scores during injection showed no statistically significant difference between articaine and lignocaine when assessed using either the WBFPRS or the FLACC scale. In contrast, during access cavity preparation, articaine produced significantly lower pain ratings on both the WBFPRS and the FLACC scale. Furthermore, during instrumentation, articaine continued to yield reduced pain responses, with a statistically significant difference observed on the FLACC scale, although the WBFPRS did not reach statistical significance.
CONCLUSION
Articaine 4% exhibited superior anesthetic performance compared with lignocaine 2%, particularly during access cavity preparation and canal instrumentation in HSPM. Although both agents showed comparable pain levels during injection, articaine achieved more profound and consistent pulpal anesthesia throughout operative phases of treatment. These findings suggest that articaine may represent a more reliable anesthetic agent for endodontic management of HSPM.
Core Tip: Achieving effective pulpal anesthesia in hypomineralized second primary molars is often challenging with conventional local anesthetics. This split-mouth clinical study demonstrates that 4% articaine provides superior intraoperative anesthetic efficacy compared with 2% lignocaine during root canal treatment of hypomineralized second primary molars, particularly during access cavity preparation and canal instrumentation. While both agents showed comparable discomfort during injection, articaine achieved more profound and consistent pulpal anesthesia. The findings underscore the clinical importance of selecting anesthetic agents with enhanced tissue penetration for hypomineralized teeth and provide evidence-based guidance for improving pain control and treatment outcomes in pediatric endodontic practice.
