Articaine Efficacy and Safety for 3 Years Old Children

Inclusion criteria: All patients have to meet all of the following inclusion criteria. They are eligible if: 1. They are Healthy (ASA 1: no acute or chronic disease, normal BMI percentile for age. They are 36 to 47 months old children. Intellectually qualified for communication. They have under gone either clinically indicated gingival abscess, dental caries or pathological root resorption or periapical radiolucency showing on the radiograph. Child's body weight at least 15 kg. Ability to communicate effectively in the Arabic or English language. Not taking any agents likely to interfere with reporting of pain (analgesics). Needs any of the following procedure: Class I cavity, Class II cavity, pulpotomy, pulpectomy, stainless steel crown (SSC) or extraction. Prior to enrollment, all radiographic data must be found acceptable by pediatric dentist. Written and singed informed consent from legally acceptable representative. Exclusion criteria: Patients are excluded from the study if: Patients have allergic to local anesthetic with epinephrine (sulphites or amide). Intellectual or severe emotional problems. patient with intellectual development is significantly lower than average and his or her ability to adapt to the environment is consequently limited like autism, Down syndrome, fragile x syndrome, fetal alcohol syndrome, and Prader-Willi syndrome. Considerable behavior problems. Parents refuse participation in the trial. History of previous bad dental experience. Primary tooth who had a history of failed pulp therapy. They have uncontrolled medical condition. They use immunosuppressive agents, rifampin, or anticonvulsants, or any other medication. Glucose 6 phosphate dehydrogenase deficiency. Congenital cardiac diseases. Seizures or uncontrolled epilepsy.