Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Randomized Controlled Trial
. 2024 Feb 26;28(3):174.
doi: 10.1007/s00784-024-05565-x.

Is it possible to extract primary maxillary molars without palatal injection?: a controlled clinical trial

Affiliations
Randomized Controlled Trial

Is it possible to extract primary maxillary molars without palatal injection?: a controlled clinical trial

Esra Ceren Tuğutlu et al. Clin Oral Investig. .

Abstract

Objectives: The absolute necessity of a palatal injection for the extraction of primary maxillary molars has never been explored, despite the fact that it is widely known that children do not tolerate local anesthetic injections into the palatal tissue well. The aim of this study was to compare separately the perception of pain in the absence of palatal injection after anesthesia and maxillary primary molar tooth extraction using different anesthetic solutions and different post-anesthetic waiting times.

Materials and methods: A single-blinded randomized controlled study was conducted in 78 participants (26 patients with palatal anesthesia (the control groups), and 26 patients with 5 min and 26 patients with 8 min post-anesthetic waiting time without palatal anesthesia (the study groups)). Subjective experiences of pain were evaluated separately after anesthesia and tooth extraction using the Visual Analog Scale (VAS) and the Wong-Baker Faces Pain Rating Scale (WBS).

Results: In terms of VAS scores obtained following administration of anesthesia, there was a statistically significant difference between the groups (p<0.05). VAS pain scores were reported to be lower in the groups without palatal anesthesia than in the groups with palatal anesthesia. No statistically significant difference was observed in VAS and Wong-Baker scores after tooth extraction between the groups with and without palatal anesthesia (P>0.05).

Conclusions: While the pain reported following administration of anesthesia was found to be higher in the groups receiving palatal anesthesia, no difference was found between the groups in the pain reported after tooth extraction.

Clinical relevance: Extraction of maxillary primary molars is possible without palatal injection by injecting 4% articaine or 2% lidocaine into the buccal vestibule of the tooth with a waiting time of 5 or 8 min.

Keywords: Articaine; Injections; Local anesthesia; Pain perception; Tooth extraction.

PubMed Disclaimer

Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Flow diagram
Fig. 2
Fig. 2
Visual Analog Scale (VAS)
Fig. 3
Fig. 3
Wong-Baker Faces Pain Rating Scale (WBS)

Similar articles

References

    1. American Academy of Pediatric Dentistry . The reference Manual of Pediatric Dentistry. Chicago, Ill: American Academy; 2023. Pain management in infants, children, adolescents and individuals with special health care needs.
    1. Bahrololoomi Z, Rezaei M. Anesthetic efficacy of single buccal infiltration of 4% articaine compared to routine inferior alveolar nerve block with 2% lidocaine during bilateral extraction of mandibular primary molars: a randomized controlled trial. J Dent Anesth Pain Med. 2021;21:61–69. doi: 10.17245/jdapm.2021.21.1.61. - DOI - PMC - PubMed
    1. Smail-Faugeron V, Muller-Bolla, Sixou MJL, Courson F. Split-mouth and parallel-arm trials to compare pain with intraosseous anaesthesia delivered by the computerised quicksleeper system and conventional infiltration anaesthesia in paediatric oral healthcare: protocol for a randomised controlled trial. BMJ open. 2015;5:e007724. doi: 10.1136/bmjopen-2015-007724. - DOI - PMC - PubMed
    1. Aminabadi NA, Farahani RM, Oskouei SG. Site-specificity of pain sensitivity to intraoral anesthetic injections in children. J Oral Sci. 2009;51:239–243. doi: 10.2334/josnusd.51.239. - DOI - PubMed
    1. Bataineh AB, Nusair YM, Al-Rahahleh RQ. Comparative study of articaine and lidocaine without palatal injection for maxillary teeth extraction. Clin Oral Invest. 2019;23:3239–3248. doi: 10.1007/s00784-018-2738-x. - DOI - PubMed

Publication types

Substances

LinkOut - more resources