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Single buccal infiltration of high concentration lignocaine versus articaine in maxillary third molar surgery

  • Received : 2020.04.02
  • Accepted : 2020.07.15
  • Published : 2020.08.31

Abstract

Background: This research evaluated the numbness produced by lignocaine at an equal or higher concentration than that of 4% articaine through a single point of injection for maxillary third molar surgery. This randomized double-blind study was conducted to compare the anesthetic efficiency of 4% lignocaine with that of 4% articaine in impacted maxillary third molar surgery using a single buccal infiltration alone. Methods: The study participants were 30 healthy patients requiring the bilateral surgical removal of symmetrically-positioned maxillary third molars. Using a split-mouth design, each patient randomly received buccal infiltration of 1.7 ml of 4% lignocaine and 1.7 ml of 4% articaine during two separate appointments. After 15 minutes of anesthetic injection, surgery was performed by the same surgeon using a consistent technique on both sides. Pinprick test pain scores of the buccal and palatal gingiva of the maxillary third molar after 10 minutes and 15 minutes latencies, pain scores during the surgery, the need for supplemental anesthesia, and patients' satisfaction with anesthetic efficiency were recorded. Surgery performed without supplemental anesthesia was categorized as successful. Results: The success rates of 4% lignocaine and 4% articaine (83.34% vs. 86.67%, P = 1.00) were not significantly different. Only 5 cases (4 cases in the articaine group and 1 case in the lignocaine group) reported mild pain and pressure sensation (NRS ≤ 1) on probing at the palatal side after 15 minutes of latency (P = 0.25). The pain scores of maxillary third molar surgery in the two groups were not significantly different (P > 0.05). Moreover, the statistical analysis confirmed the comparable patient satisfaction of two study groups (P = 0.284). Conclusion: This study provides evidence that single buccal infiltrations of 4% lignocaine and 4% articaine have comparable anesthetic efficacy and success rates for impacted maxillary third molar surgery. Both 4% lignocaine and 4% articaine can produce effective palatal anesthesia and pain control using buccal infiltration alone after 15 minutes of latency.

Keywords

References

  1. Malamed SF, Gagnon S, Leblanc D. Articaine hydrochloride: a study of the safety of a new amide local anesthetic. J Am Dent Assoc 2001; 132: 177-85. https://doi.org/10.14219/jada.archive.2001.0152
  2. Kolli NK, Nirmala SV, Nuvvula S. The effectiveness of articaine and lidocaine single buccal infiltration versus conventional buccal and palatal injection using lidocaine during primary maxillary molar extraction: A randomized control trial. Anesth Essays Res 2017; 11: 160-4. https://doi.org/10.4103/0259-1162.186589
  3. 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: 1177-82. https://doi.org/10.1016/j.ijom.2007.06.001
  4. Malamed SF. Handbook of Local Anesthetisia. 6th ed. St. Louis, Missouri, Mosby. 2013, pp 58-221.
  5. Gordon D, Heimberg RG, Tellez M, Ismail AI. A critical review of approaches to the treatment of dental anxiety in adults. J Anxiety Disord 2013; 27: 365-78. https://doi.org/10.1016/j.janxdis.2013.04.002
  6. Majid WO, 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: 737-43. https://doi.org/10.1016/j.joms.2017.11.028
  7. Lima-Junior JL, Dias-Ribeiro E, de Araujo TN, Ferreira-Rocha J, Honfi-Junior ES, Sarmento CF, et al. Evaluation of the buccal vestibule-palatal diffusion of 4% articaine hydrochloride in impacted maxillary third molar extractions. Med Oral Patol Oral Cir Bucal 2009; 14: E129-32.
  8. Kandasamy S, Elangovanb R, Johnb RR, Kumar CN. Removal of maxillary teeth with buccal 4% articaine without using palatal anesthesia: a comparative double blind study. J Oral Maxillofac Surg Med Pathol 2015; 27: 154-8. https://doi.org/10.1016/j.ajoms.2013.12.001
  9. Sharma K, Sharma A, Aseri M, Batta A, Singh V, Pilania D. Maxillary posterior teeth removal without palatal injection-truth or myth: a dilemma for oral surgeons. J Clin Diagn Res 2014; 8: ZC01-4.
  10. Brandt RG, Anderson PF, McDonald NJ, Sohn W, Peters MC. The pulpal anesthetic efficacy of articaine versus lidocaine in dentistry: a meta-analysis. J Am Dent Assoc 2011; 142: 493-504. https://doi.org/10.14219/jada.archive.2011.0219
  11. Lwanga SK, Lemeshow S. Sample Size Determination in Health studies: a practical manual. 1st ed. Geneva, World Health Organization. 1991, pp 33-5.
  12. Sirintawat N, Sawang K, Chaiyasamut T, Wongsirichat N. Pain measurement in oral and maxillofacial surgery. J Dent Anesth Pain Med 2017; 17: 253-63. https://doi.org/10.17245/jdapm.2017.17.4.253
  13. Curatolo M, Petersen-Felix S, Arendt-Nielsen L. Sensory assessment of regional analgesia in humans: a review of methods and applications. Anesthesiology 2000; 93: 1517-30. https://doi.org/10.1097/00000542-200012000-00025
  14. Lim AAT, Wong CW, Allen JC Jr. Maxillary third molar: patterns of impaction and their relation to oroantral perforation. J Oral Maxillofac Surg 2012; 70: 1035-9. https://doi.org/10.1016/j.joms.2012.01.032
  15. Pozos-Guillen A, Chavarria-Bolanos D, Garrocho-Rangel A. Split-mouth design in Paediatric Dentistry clinical trials. Eur J Paediatr Dent 2017; 18: 61-5.
  16. Pandis N, Walsh T, Polychronopoulou A, Katsaros C, Eliades T. Split-mouth designs in orthodontics: an overview with applications to orthodontic clinical trials. Eur J Orthod 2013; 35: 783-9. https://doi.org/10.1093/ejo/cjs108
  17. Fan S, Chen WL, Yang ZH, Haung ZQ. 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: 359-63. https://doi.org/10.1016/j.tripleo.2008.08.025
  18. 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: 252-7. https://doi.org/10.1007/s12663-014-0624-x
  19. Luqman U, Majeed Janjua OS, Ashfaq M, Irfan H, Mushtaq S, Bilal A. Comparison of articaine and lignocaine for uncomplicated maxillary exodontia. J Coll Physicians Surg Pak 2015; 25: 181-4.
  20. 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: 87-91. https://doi.org/10.1016/j.joms.2016.06.192
  21. Yadav S, Verma A, Sachdeva A. Buccal injection of 2% lidocaine with epinephrine for the removal of maxillary third molars. Anesth Prog 2013; 60: 95-8. https://doi.org/10.2344/0003-3006-60.3.95
  22. Uckan S, Dayangac E, Araz K. Is permanent maxillary tooth removal without palatal injection possible?. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2006; 102: 733-5. https://doi.org/10.1016/j.tripleo.2005.12.005
  23. Darawade DA, Kumar S, Budhiraja S, Mittal M, Mehta TN. A clinical study of efficacy of 4% articaine hydrochloride versus 2% lignocaine hydrochloride in dentistry. J Int Oral Health 2014; 6: 81-3.
  24. Ogaw S, Watanabe M, Kawaai H, Tada H, Yamazaki S. Lidocaine concentration in mandibular bone after subperiosteal infiltration anesthesia decreases with elevation of periosteal flap and irrigation with saline. Anesth Prog 2014; 61: 53-62. https://doi.org/10.2344/0003-3006-61.2.53
  25. Lee JM, Shin TJ. Use of local anesthetics for dental treatment during pregnancy; safety for parturient. J Dent Anesth Pain Med 2017; 17: 81-90. https://doi.org/10.17245/jdapm.2017.17.2.81
  26. El-Qutob D, Morales C, Pela'ez A. Allergic reaction caused by articaine. Allergol et Immunopathol 2005; 33: 115-6. https://doi.org/10.1157/13072924
  27. Fuzier R, Lapeyre-Mestre M, Mertes PM, Nicolas JF, Benoit Y, Didier A, et al. Immediate- and delayed-type allergic reactions to amide local anesthetics: clinical features and skin testing. Pharmacoepidemiol Drug Saf 2009; 187: 595-601.
  28. Haas DA. An update on local anesthetics in dentistry. J Can Dent Assoc 2002; 68: 546-51.