Buccal Infiltration Anesthesia Versus Inferior Alveolar Nerve Block Anesthesia

Study Overview
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Brief Summary
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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.

Detailed Description
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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 .

Official Title
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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

Conditions
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Anesthesia

Intervention / Treatment
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* Procedure: Single buccal infiltration
* Procedure: Inferior alveolar nerve block


Participation Criteria
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Eligibility Criteria
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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.

Ages Eligible for Study
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Minimum Age: 5 Years
Maximum Age: 8 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Double


Arms and Interventions

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

What is the study measuring?
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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 |