The Efficacy of Articaine Single Buccal Injection for Maxillary Premolars Extraction: A Randomized Clinical Study

Abstract

Background: The palatal injection is the most frequently used painful injection, but there is evidence that articaine 4% administered through buccal injection alone can extract maxillary teeth painlessly. Objective: A comparative study is conducted to evaluate the anesthetic efficacy of articaine 4% buccal without palatal injection for extraction of maxillary premolars compared to lidocaine 2% buccal and palatal injection. Methods: A randomized, single-blinded clinical trial was carried out involving 200 patients, of whom 104 were females and 96 were males, who were indicated for extraction of maxillary premolar teeth. The patients were randomly divided into two groups: Group A, control group: The maxillary premolar tooth extraction was performed under buccal and palatal infiltration anesthesia with 1.8 mL of 2% lidocaine hydrochloride with 1:80,000 epinephrine. Group B, a study group, extracted the maxillary premolar’s teeth under buccal anesthesia without palatal infiltration anesthesia with articaine hydrochloride 1.8 mL, 4% with 1:100,000 epinephrine. The outcome variable was the pain experienced during the extraction using the Visual Analogue Scale (VAS). Results: Statistical analysis showed that the difference in pain perception during extraction by VAS scores was statistically non-significant between the control and the study groups. Conclusions: The painful palatal injection in the extraction of maxillary premolars can be overcome by using only a buccal injection of articaine 4%.