Efficacy of Buccal Infiltration of 4% Articaine in Therapeutic Extraction of Maxillary Premolars - A Comparative Study

Abstract Introduction: Pain, being an unpleasant emotional experience, has been the focus of all treatments since time immemorial. The administration of palatal anaesthesia is rated as one of the most painful injections in dentistry. The aim of the present study was to validate whether 4% articaine hydrochloride (HCl) administered unaided as a single buccal infiltration in maxillary therapeutic extraction provided commendatory anaesthesia as compared to buccal and palatal injection for the procedure. Materials and Methods: In total, 80 patients for the removal of bilateral permanent maxillary premolars teeth enrolled in the study. About 0.8 mL of 4% articaine HCl was injected into the buccal vestibule of the tooth; tooth extraction was performed in the experimental side. A similar method with the addition of a 0.4 mL palatal injection was performed on the control side. All patients completed a 10-mm Visual Analogue Scale (VAS), 5-point Faces Pain Rating Scale for parameters such as pain during buccal injection, palatal injection, buccal and palatal flap elevation and tooth extraction. Results: The VAS scores for therapeutic extraction of maxillary premolars showed no significant difference between the two groups during extraction ( P > 0.05). Most patients described both procedures as ‘bearable’ and no patient requested an additional palatal injection to ensure comfortable extraction. Conclusion: The routine use of a palatal injection for the therapeutic extraction of maxillary premolar may not be required when Articaine/HCl is used as the local anaesthetic.