Comparison of the efficiencies of permanent maxillary tooth removal performed with single buccal infiltration versus routine buccal and palatal injection

Objective. The aim of the present study was to demonstrate whether articaine/HCl administered alone as a single buccal infiltration in maxillary tooth removal provided favorable palatal anesthesia as compared to buccal and palatal injection, for a surgical procedure. Study design. In total, 71 patients for removal of bilateral permanent maxillary teeth were enrolled in the present study. For the experimental side, 1.7 mL of 4% articaine/HCl was injected into the buccal vestibule of the tooth. After 5 minutes, tooth extraction was performed. On the control side a similar protocol was applied with the addition of a palatal injection. All patients completed a 100-mm Visual Analogue Scale (VAS), Verbal Response Scale (VRS) after both injection and then extraction, respectively. Results. According to the VAS scores, the pain of injection between buccal infiltration without a separate palatal injection and routine administration with additional palatal injection was statistically significant (P < .05). However, the VAS scores for permanent maxillary tooth removal showed no significant difference between the 2 types of injection (P > .05). All patients described both extractions as "acceptable" and no patient requested an additional palatal injection to ensure comfortable extraction. Conclusions. The routine use of a palatal injection for the removal of permanent maxillary teeth may not be required when articaine/HCl is used as the local anesthetic. (Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2009;107:359-363)