Efficacy of Buccal Infiltration with or without Palatal Injection for Posterior Maxillary Teeth Extraction – A Split-Mouth Randomized Trial

Authors

  • Abhirup Chatterjee
  • Srikanth Gadicherla
  • Sreea Roy
  • Kalyana-Chakravarthy Pentapati

Keywords:

Lidocaine, Anesthesia, Local, Maxilla, Pain Measurement, Tooth Extraction

Abstract

Objective: To evaluate the feasibility of posterior maxillary teeth extraction buccal infiltration with or without the use of palatal injection. Material and Methods: A total of 70 patients underwent extraction of bilateral maxillary posterior teeth under 2% lignocaine hydrochloride with 1:2,00000 adrenaline infiltration in this single-centric split-mouth randomized trial. The test side was administered with a buccal infiltration of 2 mL of anesthetic alone. An extended waiting period of 10 minutes was given before the commencement of the procedure. A standard protocol was followed for the control side. A single operator performed all extractions. Results: A total of 140 posterior maxillary teeth were extracted. Patients marked pain perception on a visual analogue scale in three different instances. During the administration of injections for the test side, the pain score was less than that of the control side and was statistically significant. The overall pain during the extraction procedure was comparable and statistically insignificant. The overall success of the method was 90%. Conclusion: Extraction of posterior maxillary teeth was feasible with a single buccal infiltration without palatal injection in most cases using an extended waiting period. Dentists can attempt extraction without palatal injections with optimal success. However, the alternate technique could be used when there is a necessity for rescue palatal anesthesia.

References

Nuttall NM, Bradnock G, White D, Morris J, Nunn J. Dental attendance in 1998 and implications for the future. Br Dent J 2001; 190(4):177-82. https://doi.org/10.1038/sj.bdj.4800918

Meechan JG, Howlett PC, Smith BD. Factors influencing the discomfort of intraoral needle penetration. Anesth Prog 2005; 52(3):91-4.

Munshi AK, Hegde AM, Latha R. Use of EMLA: is it an injection free alternative? J Clin Pediatr Dent 2001; 25(3):215-9. https://doi.org/10.17796/jcpd.25.3.hn62713500418728

Malamed SF, Gagnon S, Leblanc D. A comparison between articaine HCl and lidocaine HCl in pediatric dental patients. Pediatr Dent 2000; 22(4):307-11.

Gobetti JP. Dealing with Discomfort Controlling Dental Pain. J Am Dent Assoc 1992; 123(6):47-52. https://doi.org/10.14219/jada.archive.1992.0180

Roszkowski MT, Swift JQ, Hargreaves KM. Effect of NSAID administration on tissue levels of immunoreactive prostaglandin E2, leukotriene B4, and (S)-flurbiprofen following extraction of impacted third molars. Pain 1997; 73(3):339-45. https://doi.org/10.1016/S0304-3959(97)00120-6

Hawkins JM, Moore PA. Local anesthesia: advances in agents and techniques. Dent Clin North Am 2002; 46(4):719-32, ix. https://doi.org/10.1016/s0011-8532(02)00020-4

Badcock ME, Gordon I, McCullough MJ. A blinded randomized controlled trial comparing lignocaine and placebo administration to the palate for removal of maxillary third molars. Int J Oral Maxillofac Surg 2007; 36(12):1177-82. https://doi.org/10.1016/j.ijom.2007.06.001

Aslin WR. Reduced discomfort during palatal injection. J Am Dent Assoc 2001; 132(9):1277. https://doi.org/10.14219/jada.archive.2001.0372

Nasehi A, Bhardwaj S, Kamath A-T, Gadicherla S, Pentapati K-C. Clinical pain evaluation with intraoral vibration device during local anesthetic injections. J Clin Exp Dent 2015; 7(1):e23-7. https://doi.org/10.4317/jced.51643

Aminah M, Nagar P, Singh P, Bharti M. Comparison of topical anesthetic gel, pre-cooling, vibration and buffered local anesthesia on the pain perception of pediatric patients during the administration of local anesthesia in routine dental procedures. Int J Contemp Med 2017; 4(2):400-3.

Singh C, Kour G, Masih U, Srivastava M, Yadav P, Kushwah J. Insulin syringe: a gimmick in pediatric dentistry. Int J Clin Pediatr Dent 2017; 10(4):319-23. https://doi.org/10.5005/jp-journals-10005-1458

Gupta R, Kaur S, Dahiya P, Kumar M. Comparative evaluation of efficacy of EMLA and needleless jet anesthesia in non-surgical periodontal therapy. J Oral Biol Craniofacial Res 2018; 8(2):118-21. https://doi.org/10.1016/j.jobcr.2018.04.001

Jendi SK, Talathi A. Tramadol hydrochloride: An alternative to conventional local anaesthetics for intraoral procedures - a preliminary study. J Oral Biol Craniofacial Res 2019; 9(1):111-4. https://doi.org/10.1016/j.jobcr.2018.11.002

Duncan JD, Reeves GW, Fitchie JG. Technique to diminish discomfort from the palatal injection. J Prosthet Dent 1992; 67(6):901-2. https://doi.org/10.1016/0022-3913(92)90617-j

Blanton PL, Jeske AH, ADA Council on Scientific Affairs, ADA Division of Science. Avoiding complications in local anesthesia induction: anatomical considerations. J Am Dent Assoc 2003; 134(7):888-93. https://doi.org/10.14219/jada.archive.2003.0288

Uckan S, Dayangac E, Araz K. Is permanent maxillary tooth removal without palatal injection possible? Oral Surgery, Oral Med Oral Pathol Oral Radiol Endodontology 2006; 102(6):733-5. https://doi.org/10.1016/j.tripleo.2005.12.005

Sharma K. Maxillary posterior teeth removal without palatal injection –truth or myth: a dilemma for oral surgeons. J Clin Diagn Res 2014; 8(11):ZC01-ZC04. https://doi.org/10.7860/JCDR/2014/10378.5092

Fan S, Chen W liang, Yang Z hui, Huang Z quan. Comparison of the efficiencies of permanent maxillary tooth removal performed with single buccal infiltration versus routine buccal and palatal injection. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2009; 107(3):359-63. https://doi.org/10.1016/j.tripleo.2008.08.025

Iyengar AN, Dugal A, Ramanojam S, Patil VS, Limbhore M, Narla B, et al. Comparison of the buccal injection versus buccal and palatal injection for extraction of permanent maxillary posterior teeth using 4% articaine: a split mouth study. Br J Oral Maxillofac Surg 2021; 59(3):281-5. https://doi.org/10.1016/j.bjoms.2020.08.023

Sekhar GR, Nagaraju T, KolliGiri, Nandagopal V, Sudheer R, Sravan. Is palatal injection mandatory prior to extraction of permanent maxillary tooth: a preliminary study. Indian J Dent Res 2011; 22(1):100-2. https://doi.org/10.4103/0970-9290.80006

Kumaresan R, Srinivasan B, Pendayala S. Comparison of the effectiveness of lidocaine in permanent maxillary teeth removal performed with single buccal infiltration versus routine buccal and palatal injection. J Maxillofac Oral Surg 2015; 14(2):252-7. https://doi.org/10.1007/s12663-014-0624-x

Briggs M, Closs JS. A descriptive study of the use of visual analogue scales and verbal rating scales for the assessment of postoperative pain in orthopedic patients. J Pain Symptom Manage 1999; 18(6):438-46. https://doi.org/10.1016/s0885-3924(99)00092-5

Kirk K, Martin D, Steedman W, Ravey J. Comparison of Visual Analogue Scales (VAS) and Verbal Rating Scales (VRS) as assessment tools of pain intensity and pain unpleasantness. Physiotherapy 1996; 82:638. https://doi.org/10.1016/s0031-9406(05)66350-x

Lara-Muñoz C, de Leon SP, Feinstein AR, Puente A, Wells CK. Comparison of three rating scales for measuring subjective phenomena in clinical research. Arch Med Res 2004; 35(1):43-8. https://doi.org/10.1016/j.arcmed.2003.07.007

Philip BK. Parametric statistics for evaluation of the visual analog scale. Anesth Analg 1990; 71(6):710. https://doi.org/10.1213/00000539-199012000-00027

Marquie L, Duarte LR, Marine C, Lauque D, Sorum PC. How patients and physicians rate patients’ pain in a French emergency department using a verbally administered numerical rating scale and a visual analog scale. Acute Pain 2008; 10(1):104-5. https://doi.org/10.1016/j.acpain.2008.05.034

Pawar S, Desai RA, Padhye M, Shevale V, Khosa R, Keswani E, et al. Palatal injection: a myth or a reality in maxillary third molar extraction. World J Dent 2014; 5(1):28-32. https://doi.org/10.5005/JP-JOURNALS-10015-1253

Shields PW. Local anaesthesia and applied anatomy. Aust Dent J 1986; 31(5):319-25. https://doi.org/10.1111/j.1834-7819.1986.tb01218.x

Bataineh AB, Al-Sabri GA. Extraction of maxillary teeth using articaine without a palatal injection: a comparison between the anterior and posterior regions of the maxilla. J Oral Maxillofac Surg 2017; 75(1):87-91. https://doi.org/10.1016/j.joms.2016.06.192

Majid OW, Ahmed AM. The anesthetic efficacy of articaine and lidocaine in equivalent doses as buccal and non-palatal infiltration for maxillary molar extraction: a randomized, double-blinded, placebo-controlled clinical trial. J Oral Maxillofac Surg 2018; 76(4):737-43. https://doi.org/10.1016/j.joms.2017.11.028

Gholami M, Banihashemrad A, Mohammadzadeh A, Ahrari F. The efficacy of 4% articaine versus 2% lidocaine in inducing palatal anesthesia for tooth extraction in different maxillary regions. J Oral Maxillofac Surg 2021; 79(8):1643-9. https://doi.org/10.1016/j.joms.2021.02.019

Downloads

Published

2023-03-19

How to Cite

Chatterjee, A., Gadicherla, S., Roy, S., & Pentapati, K.-C. (2023). Efficacy of Buccal Infiltration with or without Palatal Injection for Posterior Maxillary Teeth Extraction – A Split-Mouth Randomized Trial. Pesquisa Brasileira Em Odontopediatria E Clínica Integrada, 23, e210215. Retrieved from https://revista.uepb.edu.br/PBOCI/article/view/1754

Issue

Section

Original Articles