Effectiveness of Articaine Buccal Infiltration Anesthesia for Mandibular Premolar Extraction: A Randomized,...

To evaluate the anesthetic adequacy of buccal versus buccal plus lingual infiltration of 4% articaine 1.8 mL for mandibular premolar teeth extraction.

A randomized, double-blinded, placebo-controlled clinical trial was conducted in which patients presented with a mandibular premolar for extraction under local anesthesia. The sample population was randomly divided into 2 equal groups: the first group received infiltration of 4% articaine 1.8 mL buccally and 0.4 mL lingually and the second group received infiltration of 4% articaine 1.8 mL buccally plus lingual injection of normal saline 0.4 mL. Pain was measured during anesthetic injection, 8 minutes after injection, and during extraction using a visual analog scale. Initial lingual anesthesia and patients' satisfaction were measured using a 5-score verbal rating scale. Statistical analyses included descriptive statistics, t test, and Pearson χ² test. Significance was set at a P value less than.05.

Seventy-two patients were included in this study (37 men and 35 women; average age, 49.8 yr). Mean pain scores during injection and extraction and satisfaction scores were comparable between study groups (P = .432, .240, and .478, respectively). Success rates were 100 and 89% in groups A and B, respectively, with no significant difference (P = .1145).

The anesthetic parameters of 1 buccal infiltration of 4% articaine 1.8 mL with and without lingual supplementation were comparable. This result could justify the use of buccal articaine infiltration as an effective alternative to the standard inferior alveolar nerve block technique for extraction of lower premolar teeth.