Anesthesia, Local Clinical Trial
Official title:
Comparison of The Efficiency of Single Buccal Infiltration Versus Buccal and Intrapapillary Infiltration Using 4% Articaine During Extraction of Primary Maxillary Molar Teeth: A Randomized Controlled Trial Split Mouth Design Study
Everyday practice in dentistry is based on giving the painless injection and achieving
adequate local anesthesia. Various techniques of reducing injection pain in children can be
broadly categorized as psychological and physical. The psychological approach includes
behavior management techniques, physical means and other recent techniques such as computer
controlled anesthesia, electronic dental anesthesia, and so forth. However, none of these
techniques have been successful in eliminating pain, fear and anxiety in children.
Direct palatal injection technique is difficult to administer without significant pain or
discomfort since there is little tissue space at these sites between the mucosa and the
underlying periosteum. Studies conducted on indirect palatal injection technique
(intrapapillary) revealed that it reduces the pain of palatal injection with the same
efficacy of anesthesia during extraction.
The desirable method to evade pain during palatal injection is just not to have one.
Maxillary molars removal without palatal or multiple injections is possible due to relatively
thin porous bone of posterior buccal maxilla that facilitates the diffusion of local
anesthetic.
The provision of intraoral palatal anesthesia can be potentially more painful for the patient
when compared to other sites of the oral cavity, as palatal tissues are tightly bound to the
hard palate with limited tissue space between it and the periosteum . As the injection is
given, pressure builds up within the palatal tissues causing pain.
Studies conducted on indirect palatal injection technique (intrapapillary) revealed that it
reduces the pain of palatal injection with the same efficacy of anesthesia during extraction.
The desirable method to evade pain during palatal injection is just not to have one. So
studies was made to evaluate the single buccal injection and its efficiency during extraction
of maxillary teeth. The relatively thin porous bone of posterior buccal maxilla facilitates
the diffusion of local anesthetic,as well as articaine can diffuse through soft and hard
tissues more reliably than other LA so that maxillary buccal infiltration of articaine
provides palatal soft tissue anesthesia.Therefore single injection eliminates the need for
multiple painful injections.
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