A blinded randomized controlled trial comparing lignocaine and placebo administration to the palate for removal of maxillary third molars

Comparison of the Effectiveness of Lidocaine in Permanent Maxillary Teeth Removal Performed with Single Buccal Infiltration Versus Routine Buccal and Palatal Injection

“…This abate in success rate towards posterior region may be attributed to the distance between the buccal and palatal side of the maxillary alveolus. Our results are in contradict to Badcock et al, who achieved 100 % success rate in maxillary third molar extraction with only a single buccal infiltration evading palatal supplementation [14]. However, the author used 2.2 mL of lidocaine for the buccal infiltration, but in our study we evaluated the palatal anesthesia with buccal infiltration of only 1.5 mL of the anesthetic solution.…”

“…For many dental patients, palatal injections prove to be a very traumatic experience alike for many dentists the administration of palatal anesthesia is one of the most traumatic procedures they perform in dentistry [24]. The conventional teaching and anatomical description of the sensory innervations of the palate would suggest a routine use of palatal injection for most of the dental procedures involving maxillary dentition [14]. Whilst, this administration of a supplementary palatal injection may be avoided if any local anesthetic would permit use of buccal infiltration to gain palatal anesthesia, as buccal vestibular injections are more likely to be pain free [2].…”

“…In accordance to this, recently, many reports have claimed that maxillary permanent teeth could be extracted by depositing local anesthesia to the buccal vestibule of the tooth without the need for palatal complementation [6,[14][15][16][17]. These studies evaluated the diffusion property of the local anesthetics from buccal vestibule to palatal aspect.…”

“…Badcock [14] quite correctly points out that the desirable method to evade pain during palatal injection is just not to have one. In accordance to this, recently, many reports have claimed that maxillary permanent teeth could be extracted by depositing local anesthesia to the buccal vestibule of the tooth without the need for palatal complementation [6,[14][15][16][17].…”

Articaine: a review of the literature

“…67 When buccal and lingual infiltrations supplemental to a lignocaine IANB were compared on mandibular teeth with IP, articaine had a significantly higher articaine can be performed without palatal anaesthesia. 21 These results corroborate findings by Badcock et al 49 who compared lignocaine and placebo saline palatal infiltrations in the extraction of maxillary third molars and concluded that when lignocaine is used in a buccal infiltration, a palatal injection of local anaesthetic may not be required. However, a clinical and magnetic resonance imaging study evaluating palatal diffusion of articaine in the maxillary first premolar and molar region did not detect the presence of anaesthesia following needle prick stimulation or articaine in the palatal tissues after buccal infiltration.…”