الفهرس 
AbstractOnly 14 pages are availabe for public view
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Abstract
The inferior alveolar nerve block is the most frequently used injection technique for achieving local anesthesia for mandibular restorative and surgical procedures. However, it does not always result in successful pulpal anesthesia and may have major postoperative complications. Recent claims that articaine has properties that allow it to diffuse through bone more efficiently have instigated investigations using mandibular buccal infiltration injections to achieve more profound pulpal anesthesia with safer and less traumatic technique. Purpose : The aim of this study is to test the efficacy and potency of articaine hydrochloride 4% (with epinephrine 1:100,000) buccal infiltration for extraction of lower posterior teeth. Patients and Methods: This clinical study was conducted on sixty patients seeking dental extraction of lower molars. Patients were classified into three groups; each group was consisted of 20 patients. group A : Inferior alveolar nerve block was performed using 2% mepivacaine hydrochloride with 1:20,000 levonordefrin. group B: Inferior alveolar nerve block was performed using 4% articaine hydrochloride with 1 :100,000 epinephrine. group C : Mandibular buccal infiltration was performed using 4% articaine hydrochloride with 1:100,000 epinephrine. Before tooth extraction, an electrical pulp tester was used to test onset and duration of anesthesia during the trial. All patients were received one ampoule of anesthesia. Pulp testing was repeated once every 2 minutes after injection for 30 minutes giving a total of 15 time points. The onset of molar pulp anesthesia was taken as the time from the beginning of at least 2 consecutive maximum readings without sensation. The duration of anesthesia was similarly taken as the time from the beginning of at least 2 consecutive maximum readings without sensation until the onset of more than 2 responses at less than maximum stimulation or the end of the 30 minutes of the trial. Results: Clinical observation and findings clarified that there was a high success rate in both anesthetic techniques (90.0% for IANB and 85.0% for the infiltration technique) with no statistical significant difference (p=0.9). The onset was more rapid in case of articaine buccal infiltration with mean of 4.47 minutes, while in the IANB technique the mean of onset time of anesthesia for articaine was 6.33 min and for mepivacaine 6.56 minutes with high statistical significant difference (p=0.0001). For all groups, no decline of anesthetic efficacy was reported over the 30 minutes study period. Conclusion : Mandibular buccal infiltration of 4% articaine with 1:100,000 epinephrine could not be considered as an alternative to inferior alveolar nerve block for lower molar extraction.