Success rate of first attempt 4% articaine para-apical anesthesia for the extraction of mandibular wisdom teeth

Abstract

Dental extraction is one of the acts that cannot be undertaken or carried out without total analgesia. Unfortunately, the success of anesthesia is not always systematic. Failures are noted during the extraction of mandibular wisdom teeth and pain management therefore remains a challenge for their extraction. The anesthesia technique and nature of the adapted anesthetic solution are controversial. However, the most commonly used technique is the Lower Alveolar Nerve Block (IANB). This technique has disadvantages (trismus, risk of intra-arterial injection and hematoma) and a failure rate of up to 88%. In some survey, 90% of 93 practitioners had difficulty obtaining proper anesthesia. Other clinical studies have also shown overall failure rates of 37%-47%, and 15%-35% on healthy lower molars. Recent studies have evaluated the success rate of articaine at between 54% and 94%, while others have shown that for mandibular teeth, articaine is more effective in para-apical anesthesia than lidocaine. Sixty subjects were selected for the study. The aim was to evaluate the overall success rate of first intention 4% articaine para-apical anesthesia during extraction of third mandibular molars. The overall success rate of para-apical anesthesia was 87%.

Keywords: Anesthesia; Articaine; Third mandibular molar; Tooth extraction.