1.Adverse Effects Of Articaine Versus Lidocaine In Pediatric Dentistry: A Meta-analysis 2.2×4 Technology To Solve Early Anterior Malocclusion

Background:Over the last few years,numerous reports have lauded the efficacy of articaine hydrochloride as a local anesthetic(LA)in dental procedures.Numerous studies have shown that articaine outperforms lidocaine in various aspects of dental treatment,leading to its widespread adoption in both adults and children.Despite the publications of comparative studies,there remains a dearth of systematic reviews examining the adverse effects of articaine versus lidocaine in randomized controlled trials.Aims:To assess the available research on the adverse effects of articaine and lidocaine in pediatric dentistry.Materials and methods:A comprehensive search was conducted on Cochrane Library,Pubmed,CBM,Embase,Web of Science and CNKI.Randomized controlled trials(RCT)that compared articaine with lidocaine in pediatric dentistry were included.Methodological quality assessment and risk of bias were determined for each of the included studies.The GRADE approach was used to assess the strength of evidence for every research.Results:A total of 333 studies were identified through electronic searches.After conducting primary and secondary assessments,eight studies were included for the final qualitative analysis.We found no significant difference in the probability of adverse reactions between articaine and lidocaine after treatment in pediatric patients(RR=1.08,95%CI[0.54-2.15],P=0.83).However,a high heterogeneity was reported among the outcomes in the investigated studies(I~2=57%),and the strength of the evidence was classified as“moderate”based on the GRADE approach.Besides,we found no significant difference in the probability of postoperative pain,postoperative soft tissue injury and edema between articaine and lidocaine in pediatric patients following treatment.Conclusions:There was moderate quality evidence suggesting no significant difference in the occurrence of adverse events between articaine and lidocaine when used for pediatric dental procedures.Both articaine and lidocaine are safe for dental treatment in children.The use of articaine in combination with IANB is inconclusive,its main advantage is in local infiltration.