Background Articaine is a very popular local anesthetic in dentistry. A lot of claims have been made about articaine over the years, both positive and negative. Many clinicians claim articaine is superior to lidocaine. However, since a study in 1995 claiming an increased risk of paresthesia, there has been debate about whether this is true or not.
Objective To review the current literature to clarify the current ambiguities about the possible superior efficacy and the alleged higher risk of paresthesia.
Data sources As a basis, a handbook on local anesthesia was read, as well as its references to the topics of interest. Afterward, the literature was searched for publications about both the efficacy and the risk of paresthesia from 1990 to 2019.
Study selection Articles about the efficacy with clear data and minimal risk of bias were selected. For paresthesia, the original articles were selected as well as more recent reviews highlighting the flaws in the first studies.
Data extraction Information about the efficacy and the possible superiority of articaine compared to lidocaine was extracted. For paresthesia, the most important historical publications were reviewed and more recent reviews were evaluated.
Data synthesis These data were synthesized in an overview consisting of two parts. First, the properties of articaine were review and what was learned about the efficacy of articaine in relation to other local anesthetics was discussed. Secondly, an overview of the history of paresthesia was given and the flaws and unclarities were highlighted.
Articaine; Epinephrine; Efficacy; Paresthesia; Dentistry.