Comparative assessment of pain and paresthesia using articaine and mepivacaine in mandibular third molar surgery: a split-mouth randomized clinical trial

Júlio César Silva de Oliveira; Izabela Fornazari Delamura; Douglas Sadrac de Biagi Ferreira; Arthur Henrique Alécio Viotto; Guilherme Alexandre Silva Prado; Ana Paula Farnezi Bassi

doi:10.1590/SciELOPreprints.17533

##article.authors##

Júlio César Silva de Oliveira São Paulo State University https://orcid.org/0000-0003-2796-5059
- Conceptualization
- Validation
- Resources
- Data Curation
- Writing – Original Draft Preparation
- Writing – Review & Editing
- Visualization
Izabela Fornazari Delamura São Paulo State University https://orcid.org/0000-0001-8046-489X
- Conceptualization
- Methodology
- Software
- Formal Analysis
- Investigation
- Writing – Original Draft Preparation
- Writing – Review & Editing
Douglas Sadrac de Biagi Ferreira São Paulo State University https://orcid.org/0000-0003-4613-9916
- Methodology
- Investigation
- Writing – Original Draft Preparation
- Writing – Review & Editing
Arthur Henrique Alécio Viotto São Paulo State University https://orcid.org/0000-0002-5368-5336
- Conceptualization
- Software
- Formal Analysis
- Writing – Original Draft Preparation
- Writing – Review & Editing
Guilherme Alexandre Silva Prado Hospital Municipal Dr. Cármino Caricchio https://orcid.org/0000-0001-6370-3035
- Methodology
- Investigation
- Data Curation
- Writing – Review & Editing
- Funding Acquisition
Ana Paula Farnezi Bassi São Paulo State University https://orcid.org/0000-0002-0031-4953
- Methodology
- Investigation
- Writing – Review & Editing
- Supervision
- Project Administration
- Funding Acquisition

DOI:

https://doi.org/10.1590/SciELOPreprints.17533

Keywords:

Third molar, local anesthesia, articaine, mepivacaine, paresthesia, pain

Abstract

Abstract

Objective: To compare postoperative pain intensity and the occurrence of paresthesia following mandibular third molar surgery using 4% articaine or 2% mepivacaine as local anesthetics. Material and method: A randomized, double-blind, split-mouth clinical trial was conducted with 30 healthy patients undergoing bilateral mandibular third molar extractions. All procedures were performed by a single surgeon. According to a randomized sequence, each patient received 2% mepivacaine on one side and 4% articaine on the contralateral side. Postoperative pain intensity was assessed at 6, 12, and 24 hours using a validated pain scale. Paresthesia was evaluated through patient questionnaires and neurosensory testing at 7 and 30 days after surgery. Result: No cases of persistent paresthesia were observed in either group. Pain intensity did not differ significantly between anesthetic solutions at 6 or 12 hours postoperatively. However, at 24 hours, patients receiving mepivacaine reported significantly higher pain scores than those receiving articaine (p < 0.05). Both anesthetics provided adequate intraoperative anesthesia. Conclusion: Both anesthetic solutions were safe and effective for mandibular third molar surgery. However, 4% articaine provided superior postoperative analgesia at 24 hours without increasing the risk of persistent paresthesia.