title: Is palatal injection mandatory prior to extraction of permanent maxillary tooth: a preliminary study.
abstract: BACKGROUND
  Even after the invention of the modern injection techniques, palatal injection still remains a painful experience for patients, and this pain is attributed to the presence of rich nerve complement and displacement of palatal mucosa during anesthesia.
  
  
  OBJECTIVE
  The aim of the present study was to demonstrate if lidocaine HCl could provide palatal anesthesia if given buccally during maxillary tooth removal without the need for a palatal injection.
  
  
  METHODS
  The study group consisted of 75 patients, and 25 were controls. All the patients in the study group had unilateral extractions. In 75 patients, 2 ml of 2% lidocaine HCl with 1:80,000 epinephrine was injected into the buccal vestibule of tooth indicated for extraction without palatal injection. After 8 min, the extraction of maxillary tooth was carried out. Twenty-five subjects in the control group underwent same protocol with palatal injection. All the patients completed a faces pain scale (FPS) and a 100 mm visual analog scale (VAS) after extraction.
  
  
  METHODS
  Unpaired t test and Chi-square test.
  
  
  RESULTS
  According to VAS and FPS scores, when comparison was carried out between permanent maxillary tooth removal with and without palatal injection, the difference in the pain levels were not statistically significant (P>0.05).
  
  
  CONCLUSIONS
  The extraction of permanent maxillary tooth is possible by depositing 2 mL of lidocaine to the buccal vestibule of the tooth without the need for palatal anesthesia.
authors.affiliation: Department of Oral and MaxilloFacial Surgery, Mamata Dental College, Khammam, Andhra Pradesh, India.
authors.forename: G Raja
authors.initials: GR
authors.lastname: Sekhar
authors.forename: T
authors.initials: T
authors.lastname: Nagaraju
authors.forename: V
authors.initials: V
authors.lastname: Nandagopal
authors.forename: R
authors.initials: R
authors.lastname: Sudheer
mesh_terms: D000328:Adult; D000766:Anesthesia, Dental / Q000379:methods*; D000772:Anesthesia, Local / Q000379:methods*; D000779:Anesthetics, Local / Q000008:administration & dosage* / Q000737:chemistry; D019229:Dentition, Permanent; D004058:Diffusion; D005260:Female; D006801:Humans; D007267:Injections / Q000009:adverse effects; D008012:Lidocaine / Q000008:administration & dosage* / Q000737:chemistry; D008297:Male; D008437:Maxilla; D008875:Middle Aged; D010146:Pain / Q000517:prevention & control; D010147:Pain Measurement; D010865:Pilot Projects; D014081:Tooth Extraction / Q000379:methods*
chemical_list: D000779:Anesthetics, Local; D008012:Lidocaine