Efficacy of Different Local Anesthetics for Pain Management in Surgical Removal of Palatally Placed Impacted Maxillary Canines: A Comparative Study

Objective: To compare the efficacy of different local anesthetics in managing pain during the surgical removal of palatally placed impacted maxillary canines. Materials and Methods: A randomized controlled study was conducted on 90 patients requiring surgical removal of palatally impacted maxillary canines. Patients were divided into three groups, each receiving a different local anesthetic: 2% lidocaine with epinephrine (Group A), 4% articaine with epinephrine (Group B), and 0.5% bupivacaine with epinephrine (Group C). Pain levels were assessed intraoperatively and postoperatively using the Visual Analog Scale (VAS). Results: Articaine demonstrated superior intraoperative pain control compared to lidocaine and bupivacaine (VAS score: 1.5 ± 0.6 vs. 3.2 ± 0.8 and 2.8 ± 0.7, respectively, P < 0.05). Postoperative pain relief was significantly prolonged in the bupivacaine group (VAS score at 6 hours: 2.1 ± 0.9 vs. 4.5 ± 1.0 for lidocaine and 3.8 ± 0.9 for articaine, P < 0.05). No severe adverse effects were reported in any group. Conclusion: Articaine provides superior intraoperative pain control, while bupivacaine offers longer-lasting postoperative analgesia. The choice of anesthetic should depend on the clinical requirements of intraoperative versus postoperative pain management.