Extraction of maxillary teeth by dental students without palatal infiltration of local anaesthesia: a randomised controlled trial.
OBJECTIVE
Palatal infiltration of local anaesthesia (LA) for maxillary tooth extractions is painful. One of the techniques for reducing the discomfort of this injection is to avoid it altogether. Given enough time, LA administered only as buccal infiltration diffuses to reach and anaesthetise the palatal tissues. The aim of this double-blind randomised controlled trial was to test the hypothesis that buccal infiltration alone of LA by dental students should be adequate for maxillary tooth extractions.


METHODS
Fifty adult patients presenting for single-tooth maxillary extractions were randomly allocated between two groups. The control group received palatal injections of 0.1 ml 2% lidocaine with 1:100,000 adrenaline, whilst the experimental group received a similar amount of saline (placebo). Extractions performed without further administration of LA were categorised as successful.


RESULTS
Palatal infiltration of lidocaine with adrenaline was significantly more effective than saline (P = 0.002). Overall buccal infiltration alone was successful in 28% patients, with a 40% success rate in the posterior maxilla.


CONCLUSIONS
Results suggest that dental students should, as a matter of routine, extract maxillary teeth with both buccal and palatal infiltration of LA, whilst buccal infiltration alone may be considered in the posterior maxilla.
Institute of Dentistry, CMH Lahore Medical College, Lahore, Pakistan.
S R
SR
Khan
Department of Oral & Maxillofacial Surgery, Institute of Dentistry, CMH Lahore Medical College, Lahore, Pakistan.
S R
SR
Qazi
D000328:Adult; D000766:Anesthesia, Dental / Q000379:methods*; D000772:Anesthesia, Local / Q000379:methods*; D004311:Double-Blind Method; D004497:Education, Dental; D005260:Female; D006801:Humans; D008297:Male; D008437:Maxilla; D008875:Middle Aged; D014081:Tooth Extraction / Q000379:methods*
buccal infiltration; dental students; lidocaine; local anaesthesia; maxillary extractions; randomised controlled trial