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Buccal versus lingual articaine infiltration for mandibular tooth anaesthesia: a randomized controlled trial

Lookup NU author(s): Dr John Meechan, Dr Ian Corbett, Professor John Whitworth


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P>Aim To compare the effectiveness of buccal and lingual local anaesthetic injections in the mandibular first molar region in obtaining pulpal anaesthesia in mandibular teeth. Methodology 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. Conclusion 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.

Publication metadata

Author(s): Meechan JG, Jaber AA, Corbett IP, Whitworth JM

Publication type: Article

Publication status: Published

Journal: International Endodontic Journal

Year: 2011

Volume: 44

Issue: 7

Pages: 676-681

Print publication date: 30/03/2011

ISSN (print): 0143-2885

ISSN (electronic): 1365-2591

Publisher: Wiley-Blackwell Publishing Ltd.


DOI: 10.1111/j.1365-2591.2011.01878.x


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