J Dent Anesth Pain Med.  2017 Jun;17(2):121-127. 10.17245/jdapm.2017.17.2.121.

Double versus single cartridge of 4% articaine infiltration into the retro-molar area for lower third molar surgery

• Sawang K
• Chaiyasamut T
• Kiattavornchareon S
• Pairuchvej V
• Bhattarai
• Wongsirichat N

• KMID: 2384473
• DOI: http://doi.org/10.17245/jdapm.2017.17.2.121

Abstract

BACKGROUND
There are no studies regarding 4% articaine infiltration injection into the retro-molar area for an impacted lower third molar (LITM) surgery. This study aimed to evaluate the efficacy of infiltration using 1.7 ml (single cartridge: SC) of 4% articaine versus 3.4 ml (double cartridges: DC) of 4% articaine with 1:100,000 epinephrine in LITM surgery. METHOD: This study involved 30 healthy patients with symmetrical LITM. The patients were assigned to receive either a DC or SC of 4% articaine with 1:100,000 epinephrine as a local anesthetic for each operation. Onset, duration, profoundness, need for additional anesthetic administration, total volume of anesthetic used, vitality of the tooth, and pain score during operation were recorded.
RESULTS
The DC of 4 % articaine had a significantly higher success rate (83.3%) than did the SC (53.3%; P < 0.05). The duration of soft tissue anesthesia was longer in the DC group. The intra-operative pain was higher in the SC group with a significant (P < 0.05) requirement for a supplementary local anesthetic.
CONCLUSION
We concluded that using DC for the infiltration injection had a higher success rate, longer duration of anesthesia, less intra-operative pain, and a lower amount of additional anesthesia than SC in the surgical removal of LITM. We recommend that a DC of 4% articaine and a 1:100,000 epinephrine infiltration in the retro-molar region can be an alternative anesthetic for LITM surgery.

Keyword

Anesthetics, Local; Impacted Tooth; Infiltration; Surgery; Third Molar

MeSH Terms

Anesthesia
Anesthetics, Local
Carticaine*
Epinephrine
Humans
Methods
Molar, Third*
Tooth
Tooth, Impacted
Anesthetics, Local
Carticaine
Epinephrine

Figure

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  Fig. 1 Infiltration was administered in the retro-molar mucosa without anesthesia of the lingual mucosa in this study.

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  Fig. 2 Type of the angulation and position of lower impacted third molar surgery in this study.

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  Fig. 3 Prolonged electric pulp testing response in the single and double cartridge groups.

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  Fig. 4 Additional anesthetic administration at each step in the single and double cartridge groups.

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  Fig. 5 Intra-operative pain score in the single and double cartridge groups.

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