Evaluation of Palatal Discomfort after Different Techniques of Buccal Infiltration of Articaine in the Maxilla

Abstract

Objective: To compare the effect of maxillary buccal infiltration (BI) and posterior superior alveolar nerve block (PSANB) using 4% articaine with 1:100,000 epinephrine on pin-prick discomfort on palatal mucosa. Methods: Thirty healthy subjects participated in this double-blind cross-over study. Each subject received two different maxillary buccal anesthetic techniques with 4% articaine with 1:100.000 epinephrine, namely BI and PSANB. Injections were given by the same operator in different sessions with 1-week interval between them. Anesthesia of palatal soft tissue was assessed by the pin-pick test with a 30G needle by an operator blinded to the type of injection. Discomfort of pin-prick was assessed at four time points using a 100 mm visual analogue scale (VAS). Data from the VAS were categorized as none to mild pain (0-30 mm) and moderate to severe pain (greater than 30 mm). Data were analyzed by Chi-square test and the results were statistically significant when p less than 0.05. Results: Although both techniques could numb the palate, the BI technique appeared less functional that the PSANB technique, not reaching the same goals in the same time interval. PSANB was more effective in stunning the palate at 5 minutes (p less than 0.001) while there was no statistically significant difference between the techniques at 10 minutes (p = 0.87). Conclusions: PSANB with 4% articaine and 1:100,000 epinephrine was more effective than BI in reducing pin-prick discomfort of palatal soft tissue at 5 minutes post-injection. Both techniques were equally effective at 10 minutes.