Article: Volume 44 Number 9 Page 838 - October 2017

  Dent Update 2017; 44: 838-845  Read article

Oral surgery:  Articaine-only Buccal Infiltrations for Mandibular Molar Extractions: An Alternative to Inferior Dental Nerve Blocks

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Abstract: This article assesses the efficacy of the articaine-only buccal infiltration technique (AOBIT) in providing LA for adult mandibular molar extractions. In 112 patients the AOBIT effectiveness was judged against the need for repeat or supplemental infiltrations and rescue 2% lidocaine inferior dental blocks (IDBs). Sufficient anaesthesia was achieved in 57% of patients using the AOBIT, with another 27% requiring an additional dose via the AOBIT. The remaining 16% required a rescue 2% lidocaine IDB. The AOBIT could be a suitable alternative to 2% lidocaine IDBs for routine adult mandibular molar extractions, and may subsequently reduce the incidence of LA-related nerve injury.

Clinical relevance: Debilitating nerve injury in relation to the administration of IDBs may be more common than we think. This article assesses the articaine-only buccal infiltration technique (AOBIT) as an alternative in providing local anaesthesia for routine adult mandibular molar extractions.

Author notes: Danyal H Awal, BDS BSc(Hons), Senior House Officer, Zehra Yilmaz, BSc(Hons), MSc, PhD, Research Affiliate, Samira Osailan, BDS, MSc, FDS RCSeng, PhD, Consultant Oral Surgeon and Tara Renton, PhD, MDSc, BDS, FRACDS(OMS), FDS RCS FHEA, Consultant Oral Surgeon, Department of Oral Surgery, King’s College Hospital, London, UK.

Objective: To recognize the articaine-only buccal infiltration technique’s potential as an alternative to inferior dental blocks for the routine extraction of mandibular molars in selected adults, therefore minimizing the risk of local anaesthesia-related inferior dental nerve injury.