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Articaine Paraesthesia Risk — NDEB AFK MCQ

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HardOral SurgeryArticaine Paraesthesia RiskNDEB AFK

Which local anaesthetic is contraindicated for use in an inferior alveolar nerve block due to the risk of persistent paraesthesia?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: D — Articaine 4%

While articaine 4% is widely used and effective, epidemiological studies have shown a statistically higher risk of prolonged paraesthesia when used for inferior alveolar nerve blocks compared to lidocaine. The higher concentration (4% vs 2%) may contribute to neurotoxicity when deposited near the IAN trunk. Many practitioners now avoid articaine for IAN blocks and use it for infiltration only, where it has superior bone penetration.

Reference: Malamed – Handbook of Local Anesthesia, 7th ed., 2020; Garisto GA et al – JADA, 2010