Comparing Articaine and Mepivacaine Without Palatal Injection in Pain Assessment During Maxillary Teeth Extraction

Melaka Manipal Medical College60 enrolled

Overview

This study compares the the efficacy of buccal infiltration of 4% Articaine and 2% Mepivacaine without any palatal injection during extraction of maxillary teeth. One group of patient receives buccal infiltration of Articaine and another group receives buccal infiltration of Mepivacaine.

Dense local anesthesia is required to reduce pain during extraction of tooth. Administration of local anesthesia to the palatal mucosa is proved to be the most painful due to its firm adherence to the underlying periosteum and also it's abundant nerve supply. Articaine has greater lipid solubility and high bone penetration property. Mepivacaine is proven to be the safest local anaesthetic agent. Avoidance of a palatal injection during extraction will benefit the patient by reducing pain and anxiety to a greater extent. So this study compares the bone penetration property between Articaine and Mepivacaine by assessing the pain in the palatal mucosa while extracting the tooth using only buccal infiltration.

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

SUPPORTIVE_CARE

Masking

DOUBLE

Enrollment

Conditions

Pain

Interventions

buccal infiltration of 4% Articaine with EpinephrineDRUG

Articaine Hydrochloride 4 % / Epinephrine 1:200,000 1.8 ML Cartridge

buccal infiltration of 2% Mepivacaine with EpinephrineDRUG

Mepivacaine Hydrochloride 2% Epinephrine 1:200,000 2.2 Ml Cartridge

Eligibility

Sex: ALLMin age: 18 YearsHealthy volunteers:

Medical Language ↔ Plain English

Inclusion Criteria: * Patients aged 18 years and above * Patients requiring extraction of maxillary teeth which are grossly decayed, grade I mobile, root stumps or indicated for therapeutic extractions. * Healthy patients ( ASA I ) or patients with mild systemic disease with no functional limitations (ASA II). * Patients who are not allergic to the drugs used in the study Exclusion Criteria: * Patients with periapical infections. * Patients who are on concurrent treatment with NSAIDs and corticosteroids

Locations (1)

Melaka Manipal Medical College

Malacca, Malaysia

Outcomes

Primary Outcomes

Measurement of pain intensity

pain intensity in the palatal mucosa is measured using Visual Analogue Scale during instrumentation to check objective symptoms of numbness. The pain is marked from 0-100 mm in a 100 mm visual analogue scale ( 0= no pain, 100= extremely severe pain).

Time frame: 10 minutes after the administration of the drug

Measurement of pain intensity

pain intensity in the palatal mucosa is measured using Visual Analogue Scale during flap elevation procedure . The pain is marked from 0-100 mm in a 100 mm visual analogue scale ( 0= no pain, 100= extremely severe pain).

Time frame: through the extraction procedure

Measurement of pain intensity

pain intensity is measured using Visual Analogue Scale during extraction of tooth. The pain is marked from 0-100 mm in a 100 mm visul analogue scale ( 0= no pain, 100= extremely severe pain).

Time frame: Through the extraction procedure

Secondary Outcomes

Response rate

the total number of patients with pain score more than 40 mm in visual Analogue Scale resulting in a palatal injection.

Time frame: Through the extraction procedure

Data from ClinicalTrials.gov

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