Buccal versus buccal palatal infiltration for pulpal anesthesia using 2% lidocaine and 4% articaine: A randomized controlled trial

Background: The inability in achieving complete pulpal anesthesia with standard buccal infiltration especially in cases with SIP used for maxillary teeth. The study aimed to compare the anesthetic efficacy of buccal and buccal plus palatal infiltration technique using 2% lidocaine and 4% articaine i...

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Main Authors: Umesh Kumar, Nikita Garg, Ruchi Vashisht, Amrita Kumari, Charan Kamal Kaur, Akhil Rajput
Format: Article
Language:English
Published: Elsevier 2024-03-01
Series:Journal of Oral Biology and Craniofacial Research
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Online Access:http://www.sciencedirect.com/science/article/pii/S2212426824000277
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author Umesh Kumar
Nikita Garg
Ruchi Vashisht
Amrita Kumari
Charan Kamal Kaur
Akhil Rajput
author_facet Umesh Kumar
Nikita Garg
Ruchi Vashisht
Amrita Kumari
Charan Kamal Kaur
Akhil Rajput
author_sort Umesh Kumar
collection DOAJ
description Background: The inability in achieving complete pulpal anesthesia with standard buccal infiltration especially in cases with SIP used for maxillary teeth. The study aimed to compare the anesthetic efficacy of buccal and buccal plus palatal infiltration technique using 2% lidocaine and 4% articaine in permanent maxillary first molars with the diagnosis of symptomatic irreversible pulpitis (SIP). Material and method: One hundred and twenty-three patients with clinical diagnosis of SIP, aged 18–50 years were randomly allocated to three treatment groups (N = 41). Group 1(BIL): Buccal infiltration technique using 2% lidocaine with 1:80,000 adrenaline. Group 2(BPIL): combination of buccal plus palatal infiltration using 2% Lidocaine with 1:80,000 adrenaline. Group 3(BIA): Buccal infiltration using 4% articaine with 1:100,000 adrenaline. Pain intensity of patients were recorded before and after the administration of local anesthesia during endodontic procedure that is during caries removal, access preparation and pulp removal using Heft-Parker Visual Analog Scale (HP-VAS). Success was defined by “no pain (0 mm)” or “mild pain (0–54 mm)” during endodontic procedure. The anesthetic efficacy rates were analyzed using chi-square tests, age differences using one-way ANOVA. Results: The final analysis included total of 117 patients. Higher success was observed in group II (85%) in comparison to group I (69%) and group III (74%), but the difference was statistically nonsignificant (p > 0.05). Our results demonstrated a nonsignificant difference between genders in all three groups (p > 0.05). Conclusion: The use of buccal plus palatal infiltration and 4% articaine can provide effective anesthesia as standard buccal infiltration and 2% lidocaine for patients with SIP in maxillary first molars.
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spelling doaj-art-8b7f5bc56fdc4c28a763bcb667455a182024-11-23T06:30:41ZengElsevierJournal of Oral Biology and Craniofacial Research2212-42682024-03-01142205210Buccal versus buccal palatal infiltration for pulpal anesthesia using 2% lidocaine and 4% articaine: A randomized controlled trialUmesh Kumar0Nikita Garg1Ruchi Vashisht2Amrita Kumari3Charan Kamal Kaur4Akhil Rajput5Oral Health Sciences Centre, Post Graduate Institute of Medical Education and Research, Chandigarh, India, 160012; Corresponding author. Unit of Endodontics, India.Oral Health Sciences Centre, Post Graduate Institute of Medical Education and Research, Chandigarh, India, 160012Oral Health Sciences Centre, Post Graduate Institute of Medical Education and Research, Chandigarh, India, 160012Oral Health Sciences Centre, Post Graduate Institute of Medical Education and Research, Chandigarh, India, 160012Government Multi-speciality hospital, Sector-16, Chandigarh, IndiaDr. BSA Medical college and hospital, Rohini, New delhi, IndiaBackground: The inability in achieving complete pulpal anesthesia with standard buccal infiltration especially in cases with SIP used for maxillary teeth. The study aimed to compare the anesthetic efficacy of buccal and buccal plus palatal infiltration technique using 2% lidocaine and 4% articaine in permanent maxillary first molars with the diagnosis of symptomatic irreversible pulpitis (SIP). Material and method: One hundred and twenty-three patients with clinical diagnosis of SIP, aged 18–50 years were randomly allocated to three treatment groups (N = 41). Group 1(BIL): Buccal infiltration technique using 2% lidocaine with 1:80,000 adrenaline. Group 2(BPIL): combination of buccal plus palatal infiltration using 2% Lidocaine with 1:80,000 adrenaline. Group 3(BIA): Buccal infiltration using 4% articaine with 1:100,000 adrenaline. Pain intensity of patients were recorded before and after the administration of local anesthesia during endodontic procedure that is during caries removal, access preparation and pulp removal using Heft-Parker Visual Analog Scale (HP-VAS). Success was defined by “no pain (0 mm)” or “mild pain (0–54 mm)” during endodontic procedure. The anesthetic efficacy rates were analyzed using chi-square tests, age differences using one-way ANOVA. Results: The final analysis included total of 117 patients. Higher success was observed in group II (85%) in comparison to group I (69%) and group III (74%), but the difference was statistically nonsignificant (p > 0.05). Our results demonstrated a nonsignificant difference between genders in all three groups (p > 0.05). Conclusion: The use of buccal plus palatal infiltration and 4% articaine can provide effective anesthesia as standard buccal infiltration and 2% lidocaine for patients with SIP in maxillary first molars.http://www.sciencedirect.com/science/article/pii/S2212426824000277Symptomatic irreversible pulpitisMaxillary first molarLocal anesthesiaBuccal infiltrationArticaine
spellingShingle Umesh Kumar
Nikita Garg
Ruchi Vashisht
Amrita Kumari
Charan Kamal Kaur
Akhil Rajput
Buccal versus buccal palatal infiltration for pulpal anesthesia using 2% lidocaine and 4% articaine: A randomized controlled trial
Journal of Oral Biology and Craniofacial Research
Symptomatic irreversible pulpitis
Maxillary first molar
Local anesthesia
Buccal infiltration
Articaine
title Buccal versus buccal palatal infiltration for pulpal anesthesia using 2% lidocaine and 4% articaine: A randomized controlled trial
title_full Buccal versus buccal palatal infiltration for pulpal anesthesia using 2% lidocaine and 4% articaine: A randomized controlled trial
title_fullStr Buccal versus buccal palatal infiltration for pulpal anesthesia using 2% lidocaine and 4% articaine: A randomized controlled trial
title_full_unstemmed Buccal versus buccal palatal infiltration for pulpal anesthesia using 2% lidocaine and 4% articaine: A randomized controlled trial
title_short Buccal versus buccal palatal infiltration for pulpal anesthesia using 2% lidocaine and 4% articaine: A randomized controlled trial
title_sort buccal versus buccal palatal infiltration for pulpal anesthesia using 2 lidocaine and 4 articaine a randomized controlled trial
topic Symptomatic irreversible pulpitis
Maxillary first molar
Local anesthesia
Buccal infiltration
Articaine
url http://www.sciencedirect.com/science/article/pii/S2212426824000277
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