title: Anesthetic efficacy of a combination palatal and buccal infiltration of the maxillary first molar.
abstract: BACKGROUND
  The purpose of this prospective, randomized, single-blind crossover study was to evaluate the anesthetic efficacy of a combination palatal and buccal infiltration of the maxillary first molar.
  
  
  METHODS
  Using a crossover design, 40 subjects received two sets of maxillary first molar infiltrations at two separate appointments spaced at least 1 week apart. The anesthetic used in this study was 2% lidocaine with 1:100,000 epinephrine. One set of infiltrations consisted of a buccal infiltration of 1.8 mL of anesthetic and a palatal infiltration of 0.5 mL of anesthetic. The other set consisted of a buccal infiltration of 1.8 mL of anesthetic and a mock palatal infiltration. The first molar was pulp tested in 4-minute cycles for a total of 60 minutes. Anesthetic success was defined as no subject response to two consecutive 80 readings with an electric pulp tester.
  
  
  CONCLUSIONS
  The success rates were 88% for the buccal infiltration and 95% for the buccal plus palatal infiltration. The difference was not statistically significant. The buccal plus palatal infiltration significantly increased the incidence of pulpal anesthesia from 21 minutes through 57 minutes. Although there was an increased incidence of pulpal anesthesia with the combination buccal plus palatal infiltration, anesthesia was not provided for 60 minutes.
authors.affiliation: The Ohio State University, Columbus, Ohio, USA.
authors.forename: Anna
authors.initials: A
authors.lastname: Guglielmo
authors.forename: Melissa
authors.initials: M
authors.lastname: Drum
authors.forename: Al
authors.initials: A
authors.lastname: Reader
authors.forename: John
authors.initials: J
authors.lastname: Nusstein
mesh_terms: D000328:Adult; D000766:Anesthesia, Dental / Q000379:methods*; D000772:Anesthesia, Local / Q000379:methods*; D000779:Anesthetics, Local / Q000008:administration & dosage*; D018592:Cross-Over Studies; D003782:Dental Pulp / Q000187:drug effects*; D003791:Dental Pulp Test; D004837:Epinephrine / Q000008:administration & dosage; D005260:Female; D006801:Humans; D007267:Injections; D008012:Lidocaine / Q000008:administration & dosage; D008297:Male; D008437:Maxilla / Q000187:drug effects; D008963:Molar / Q000187:drug effects*; D009061:Mouth Mucosa; D010159:Palate; D011446:Prospective Studies; D016037:Single-Blind Method; D013997:Time Factors; D016896:Treatment Outcome; D014662:Vasoconstrictor Agents / Q000008:administration & dosage; D055815:Young Adult
chemical_list: D000779:Anesthetics, Local; D014662:Vasoconstrictor Agents; D008012:Lidocaine; D004837:Epinephrine