Is nasopalatine nerve block still mandated for the extraction of maxillary anterior teeth?

Abstract

Aim This study was conducted to investigate the effectiveness of a single labial injection of 4% articaine for the extraction of maxillary anterior teeth without the need for nasopalatine supplementary injection.Materials and methods A prospective, controlled, split-mouth clinical study was performed to evaluate the clinical performance of 4% articaine as a single labial infiltration anaesthesia for the extraction of maxillary anterior teeth and to compare it with the routine method of labial injection along with a supplementary nasopalatine injection using 2% lidocaine. Statistical analyses were performed, with the statistical significance being set at 5% level.Results A total of 37 patients met the inclusion criteria, and a statistically significant difference was observed in the reported pain during injection between the single labial articaine injection and the routine labial and palatal lidocaine injections (P <0.001). The extraction of maxillary anterior teeth was possible without the need for an additional nasopalatine injection in all the study patients (n = 37). The difference between both groups was statistically non-significant in terms of the pain encountered during extraction (P = 0.22).Conclusion With the use of 4% articaine as a single labial infiltration anaesthesia, nasopalatine nerve block for the extraction of maxillary anterior teeth may become an outdated modality.