Articaine Onset — MFDS Part 1 MCQ

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ModeratePharmacologyArticaine OnsetMFDS Part 1

For maxillary dental infiltration, which local anaesthetic agent is commonly supplied as a 4% adrenaline-containing dental solution and has evidence of a shorter onset of pulpal anaesthesia than 2% lidocaine with adrenaline?

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Correct answer: E — Articaine

Articaine is correct. When used for dental infiltration in its usual 4% adrenaline-containing formulation, it has demonstrated a shorter onset of pulpal anaesthesia than 2% lidocaine with adrenaline. Its thiophene ring contributes to lipid solubility and tissue diffusion. Lidocaine remains a standard rapid-onset dental anaesthetic but is slower in the cited maxillary infiltration comparison. Mepivacaine also has a relatively rapid onset, making it the strongest distractor, but it cannot be declared universally faster than articaine. Prilocaine has an intermediate clinical profile, while bupivacaine is principally selected for prolonged duration rather than rapid onset. Onset must always be interpreted in relation to formulation, injection site and technique.

Reference: Costa CG et al. Onset and duration periods of articaine and lidocaine on maxillary infiltration. Quintessence International. 2005;36:197–201. https://pubmed.ncbi.nlm.nih.gov/15887505/