The effectiveness of mandibular infiltration compared to mandibular block anesthesia in treating primary molars in children

Mandibular infiltration has been routinely avoided in treating mandibular molars because of its questionable adequacy. The purpose of our investigation was to determine the effectiveness of mandibular infiltration compared with mandibular block in treating primary molars in children, and to relate the effectiveness to age and type of treatment performed. The study population consisted of 89 cooperative children, 3 to 9 years old, requiring the same type of treatment on contralateral mandibular molars. The half-mouth study design was used. Dental procedures included class I and II amalgam restorations, stainless steel crowns, formocresol pulpotomies, and extractions. Evaluations of pain and behavior for each anesthesia technique and type of treatment were made using sounds, motor, and ocular changes indicating pain and the Frankl Behavior Rating Scale. Evaluations were made upon probing, rubber dam placement, and during tooth preparation and extraction. No statistically significant differences was found between the two anesthetic techniques for either behavior or pain when performing amalgam or stainless steel crown restorations (P = 0.05). Mandibular infiltration was less effective than mandibular block for pulpotomy and extraction (P = 0.05). No significant relationship to age as determined by primary or mixed dentition, for effectiveness was noticed.