title: Patient's pain perception during mandibular molar extraction with articaine: a comparison study between infiltration and inferior alveolar nerve block.
abstract: OBJECTIVE
  The aim of this study was to investigate the effectiveness of a local anesthetic agent comprising of 4 % articaine with 1:100,000 adrenaline, administered through an infiltration technique prior to the extraction of mandibular permanent first molar teeth.
  
  
  METHODS
  The study adopted a split mouth approach and involved patients who needed simple extractions of permanent mandibular first molar teeth on both sides. A combination of buccal and lingual infiltrations was used on one side, while the conventional inferior alveolar nerve block (IANB) technique, with a 1.8-ml cartridge of 4 % articaine with 1:100,000 epinephrine, was administered to the other. The patients' pain perception was assessed using visual analogue scale (VAS) and verbal rating scale (VRS) after the injection, followed by extraction.
  
  
  RESULTS
  As a part of the study, 104 teeth were extracted from mouths of 52 patients. The difference in pain perception was statistically insignificant (p > .05) regarding the local anesthetic injection between the two techniques. The difference in pain perception regarding the extraction between the two techniques was also statistically insignificant (p < .05).
  
  
  CONCLUSIONS
  No difference in pain perception between the two techniques among the study population was noted. This indicates that the extraction of permanent mandibular first molar teeth is possible without the administration of an IANB with the use of 4 % articaine with 1:100,000 epinephrine.
  
  
  CONCLUSIONS
  The buccal and lingual infiltrations are slightly less painful than the conventional IANB technique.
authors.affiliation: Faculty of Dentistry, Jordan University of Science and Technology, P.O. Box 3030, Irbid, Jordan. anwar@just.edu.jo.
authors.forename: Anwar B
authors.initials: AB
authors.lastname: Bataineh
authors.affiliation: Faculty of Dentistry, Jordan University of Science and Technology, P.O. Box 3030, Irbid, Jordan.
authors.forename: Majid A
authors.initials: MA
authors.lastname: Alwarafi
mesh_terms: D000293:Adolescent; D000328:Adult; D000766:Anesthesia, Dental / Q000379:methods*; D000779:Anesthetics, Local / Q000008:administration & dosage*; D002355:Carticaine / Q000008:administration & dosage*; D004837:Epinephrine / Q000008:administration & dosage; D005260:Female; D006801:Humans; D008297:Male; D008334:Mandible; D008340:Mandibular Nerve; D008875:Middle Aged; D008963:Molar / Q000601:surgery*; D009407:Nerve Block / Q000379:methods*; D010147:Pain Measurement; D011446:Prospective Studies; D014081:Tooth Extraction; D016896:Treatment Outcome
chemical_list: D000779:Anesthetics, Local; D002355:Carticaine; D004837:Epinephrine
keywords: Articaine; Inferior alveolar nerve block; Infiltration; Mandibular first molar; Tooth extraction