title: Buccal versus lingual articaine infiltration for mandibular tooth anaesthesia: a randomized controlled trial.
abstract: OBJECTIVE
  To compare the effectiveness of buccal and lingual local anaesthetic injections in the mandibular first molar region in obtaining pulpal anaesthesia in mandibular teeth.
  
  
  METHODS
  Twenty healthy volunteers received 1.8 mL of 4% articaine with 1 : 100,000 epinephrine as a buccal or lingual infiltration in the mandibular first molar region in a randomized double-blind cross-over design. The responses of the first molar, a premolar and the lateral incisor teeth were assessed using an electronic pulp tester over a 47-min period. Successful anaesthesia was defined as no response to maximum stimulus from the pulp tester on two or more consecutive tests. Success between techniques was analysed using the McNemar test and variations between teeth were compared with Chi-square.
  
  
  RESULTS
  The number of no responses to maximum stimulation from an electronic pulp tester was significantly greater for all test teeth after the buccal injection compared with the lingual approach (P < 0.001). Successful anaesthesia was more likely following the buccal infiltration compared with the lingual method for molar (65% and 10%, respectively) and premolar (90% and 15%, respectively) teeth. There was no difference in anaesthetic success for the lateral incisor.
  
  
  CONCLUSIONS
  Buccal infiltration at the first mandibular molar is more effective than lingual infiltration in the same region in obtaining anaesthesia of the mandibular first molar and premolar teeth.
authors: Oral Health Research Group, School of Dental Sciences, Newcastle University, Newcastle upon Tyne, UK. J.G.Meechan@ncl.ac.uk
authors: J G
authors: JG
authors: Meechan
authors: A A
authors: AA
authors: Jaber
authors: I P
authors: IP
authors: Corbett
authors: J M
authors: JM
authors: Whitworth
mesh_terms: D000328:Adult; D000766:Anesthesia, Dental; D000779:Anesthetics, Local / Q000008:administration & dosage*; D001641:Bicuspid / Q000187:drug effects; D002355:Carticaine / Q000008:administration & dosage*; D018592:Cross-Over Studies; D003724:Dental Arch / Q000187:drug effects; D003782:Dental Pulp / Q000187:drug effects*; D003791:Dental Pulp Test; D004311:Double-Blind Method; D004837:Epinephrine / Q000008:administration & dosage; D005260:Female; D006801:Humans; D007180:Incisor / Q000187:drug effects; D007267:Injections; D008297:Male; D008334:Mandible / Q000187:drug effects*; D008963:Molar / Q000187:drug effects*; D009061:Mouth Mucosa; D011446:Prospective Studies; D013997:Time Factors; D014059:Tongue; D014662:Vasoconstrictor Agents / Q000008:administration & dosage; D055815:Young Adult
chemical_list: D000779:Anesthetics, Local; D014662:Vasoconstrictor Agents; D002355:Carticaine; D004837:Epinephrine