Buccal Infiltration Anesthesia Versus Inferior Alveolar Nerve Block Anesthesia

Comparative Evaluation of the Effectiveness of Buccal Infiltration Anesthesia Versus Inferior Alveolar Nerve Block Anesthesia for the Extraction of Primary Mandibular Molars: A Randomized Controlled Study

This study aims to evaluate the effectiveness of single buccal local infiltration when compared to buccal local infiltration with intrapapillary infiltration and inferior alveolar nerve block anesthesia in primary mandibular molar extractions.

Study Overview

• Status: Completed
• Conditions: Anesthesia
• Intervention / Treatment: Procedure: Single buccal infiltration; Procedure: Inferior alveolar nerve block

Detailed Description

Effective pain control is essential in providing children with successful dental treatment. Without it, negative experiences may result in anxiety and fear-related behaviors towards subsequent dental treatment. Local anesthesia is the cornerstone of pain control in dentistry. Choosing the right local anesthetic technique is of special significance .

The inferior alveolar nerve block (IANB) is a common practice for anesthetizing mandibular molars and/or premolars on one side of the jaw. It is achieved by depositing local anesthetic solution at the entrance to the mandibular canal, which inhibits the transmission of action potentials along the inferior alveolar nerve.

Administering an IANB can be technique sensitive and failure rates are reported to be up to 20%, due to anatomical variations in the position of the mandibular foramen and accessory innervations. This effect may be compounded for those who are not used to anesthetizing children .

However, Supraperiosteal infiltration has the advantages of easier administration when compared to block anesthesia, shorter anesthetic duration, and generally does not anesthetize the lips .

An ideal local anesthetic should provide maximum efficacy, through a minimal number of injections, using techniques that provide the least discomfort, causing negligible adverse effects .

• Study Type: Interventional
• Enrollment (Actual): 112
• Phase: Not Applicable

Contacts and Locations

Study Locations

• Egypt
  • Cairo, Egypt
    • Cairo University

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 5 years to 8 years (Child)
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: All

Description

Inclusion Criteria:

• Badly decayed primary mandibular molars indicated for extraction with not less than half of the root length present.
• Children ranging in age from 5-8 years

Exclusion Criteria:

.Allergies to local anesthetics.

• History of significant medical conditions.
• Children under any medications.
• Presence of abscess, sinus opening.
• Uncooperative children without access to or with difficulty accessing dental care.

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: Double

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Single buccal infiltration of articaine anesthesia; The local anesthetic solution will be administered using single buccal infiltration with articaine anesthesia.	Procedure: Single buccal infiltration; injecting local anaesthetic solution into the soft tissues of the buccal sulcus adjacent to the target tooth.; Other Names: Articaine buccal infiltration
Active Comparator: Inferior alveolar nerve block of lidocaine anesthesia; The anesthetic solution will be administered using inferior alveolar nerve block with lidocaine anesthesia.	Procedure: Inferior alveolar nerve block; Injection of local anesthetic solution into the pterygomandibular space to access the inferior alveolar nerve before it enters the mandible.; Other Names: Lidocaine nerve block

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Assessment of intraoperative pain	Wong Baker Faces Pain Rating Scale consists of a set of cartoon faces with varying facial expressions ranging from a smile/laughter to tears with numerical value from 0 to 5 where where zero indicates no pain and 5 indicate severe pain	through treatment completion, an average of 1 hour

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
intraoperative pain	Faces, Legs, Activity, Cry, and Consolability scale with score from 0 to 10 where zero indicates no pain and 10 indicate severe pain	through treatment completion, an average of 1 hour
The onset of the anesthetic effect	stopwatch	up to 24 hours
duration of the anesthetic effect	stopwatch	up to 24 hours

Collaborators and Investigators

• Sponsor: Cairo University
• Investigators: Principal Investigator: marwa m elchaghaby, phd, marwaaly2003@yahoo.com

Study record dates

Study Major Dates

• Study Start (Actual): September 1, 2021
• Primary Completion (Actual): March 1, 2022
• Study Completion (Actual): March 3, 2022

Study Registration Dates

• First Submitted: January 3, 2022
• First Submitted That Met QC Criteria: January 31, 2022
• First Posted (Actual): February 2, 2022

Study Record Updates

• Last Update Posted (Actual): November 16, 2022
• Last Update Submitted That Met QC Criteria: November 13, 2022
• Last Verified: November 1, 2022

More Information

Terms related to this study

• Additional Relevant MeSH Terms: Physiological Effects of Drugs; Molecular Mechanisms of Pharmacological Action; Anti-Arrhythmia Agents; Central Nervous System Depressants; Peripheral Nervous System Agents; Sensory System Agents; Anesthetics; Membrane Transport Modulators; Anesthetics, Local; Voltage-Gated Sodium Channel Blockers; Sodium Channel Blockers; Lidocaine
• Other Study ID Numbers: Anesthetic techniques

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No