Comparative Evaluation of the Efficacy and Onset of Local Anesthesia Using Buffered 2% Lidocaine with 1:100,000 Adrenaline, Non-buffered 2% Lidocaine with 1:100,000 Adrenaline, Buffered 4% Articaine with 1:100,000 Adrenaline and Non-buffered 4% Articaine with 1:100,000 Adrenaline in Dental Extraction.

Aim: To compare the efficacy and onset of local anesthesia using buffered versus non-buffered 2% lidocaine with 1:100,000 adrenaline and 4% articaine with 1:100,000 adrenaline in dental extraction.

Methodology: A prospective, clinical study was carried out in oral and maxillofacial surgery department. Twenty-eight patients were considered in the study and were divided into 4 groups. Each group randomly received either buffered 2% lidocaine with 1:100,000 adrenaline, non-buffered 2% lidocaine with 1:100,000 adrenaline, buffered 4% articaine with 1:100,000 adrenaline or non-buffered 4% articaine with 1:100,000 adrenaline. The outcome variable was onset of anesthesia and effectiveness of anesthesia in buffered and non-buffered group.

Results: Results showed that the mean onset of time and efficacy of local anesthesia was significantly better in buffered when compared with non-buffered local anesthetic solution with adrenaline.

Conclusion: In conclusion, the addition of sodium bicarbonate as a buffering agent decreases time of onset and increases the effectiveness of local anesthetics, thus providing comfort to the patient. The mean onset of time for first symptom as well as lip numbness was more for non-buffered lidocaine followed by non-buffered articaine, buffered lidocaine and buffered articaine. The mean onset of time for subjective and objective symptoms was more for non-buffered anesthetic solution as compared to buffered anesthetic solution. VAS readings were not statistically significant among the four groups.