Efficacy of 4% Articaine and 2% Mepivacaine without Palatal Injection in Assessing Pain during Maxillary Teeth Extraction: A Randomised Clinical Trial
Ann Mary George,
Melaka Manipal Medical College, Jalan Batu Hampar, Bukit Baru, Melaka-75150, Malaysia.
Introduction: Local anaesthesia is used to reduce pain while performing the extraction of teeth. But local anaesthesia injection itself causes pain while administration, especially palatal injections. Many patients avoid dental extractions due to the same reason, which can lead to life threatening situations. In the present-day dental practice, providing treatment with least amount of pain and discomfort is the key.
Aim: The study was done to compare the efficacy of 4% articaine and 2% mepivacaine without palatal injection for assessment of pain during maxillary teeth extraction.
Materials and Methods: A double blinded pilot randomised clinical trial was performed on 54 patients which required extraction of anterior and posterior maxillary teeth. Single buccal infiltration of 1 mL of 4% Articaine hydrochloride with adrenaline 1:200000 solution was given to 27 patients in study group A and 1 mL of 2% Mepivacaine with adrenaline 1:200000 was given to 27 patients in control group B. Objective signs of palatal anaesthesia was checked and pain was assessed by VAS scale. Mann-Whitney U test was used to compare the pain at different stages of extraction between group A and group B. Chi-square test was used to compare palatal injection needed between groups. The statistical analysis was performed with the SPSS version 15.
Results: The subjects who required re-anaesthesia is significantly higher percentage (70.4%) in the Mepivacaine group than compared to Articaine group (29.6%) (p=0.003). Hence, patients in the group where 4% articaine was administered showed significant reduction of pain without palatal anaesthesia.
Conclusion: Articaine 4% was superior in comparison to 2% Mepivacaine in its characteristics of bony diffusion and there was no absolute requirement to use palatal infiltration for the extraction of maxillary teeth.