Nine RCTs (n=1,725 participants, range 18 to 1,325) were included. Six trials were judged to have appropriate sequence generation. Four trials had adequately concealed treatment allocation. Seven trials were appropriately blinded. All trials either handled or analysed losses appropriately. Overall, five studies were judged to have rated poorly on the validity assessment.
Articaine was significantly more likely to achieve an anaesthetic success in the first molar area compared to lignocaine (RR 1.31, 95% CI 1.12 to 1.54; seven RCTs). Articaine was associated with significantly more pain than lignocaine post-infection on day zero (WMD 6.49, 95% CI 0.02 to 12.96; three RCTs), day one (WMD 5.35, 95% CI 0.83 to 9.88; three RCTs), day two (WMD 3.81, 95% CI 0.32 to 7.31; three RCTs) and day three (WMD 1.10, 95% CI 0.18 to 2.02; three RCTs). There was no difference between articaine and lignocaine in terms of onset of action in minutes (two RCTs), pain during solution deposition (three RCTs) and adverse events (four RCTs).
There was no evidence of heterogeneity for any analyses.