As per a recent prospective research study published in Journal of the Korean Association of Oral and Maxillofacial Surgeons, the buccal infiltration injection without palatal injection can be used as a substitute to the conventional injection for the treatment of maxillary impacted third molar surgery (MITMS).

Palatal infiltration is the most painful anesthesia procedure for MITMS causing distress and dislike to dental treatment in patients. This study assessed the anesthetic efficacy of buccal infiltration injection without palatal injection in MITMS.

A total of 28 healthy symmetrical bilateral MITMS patients with a mean age of 23 years were randomly allocated to 2 groups: Study group- Buccal infiltration injections without palatal injection and Control group- Buccal with palatal infiltration cases via 4% articaine and 1:100,000 epinephrine. Visual analogue scale (VAS) and a numeric rating scale (NRS) following each injection and extraction procedure were used to assess pain.

The hemodynamic parameters, success rate and other demanded local anesthetic were also evaluated. Between both groups, the results portrayed that the pain linked with local anesthetic injections were considerably different (Figure 1); but this was not the case with the success rate.

Figure 1: Variation in pain intensity via NRS at different stages of MITMS

A significant difference in systolic pressure during incision, bone removal, and tooth elevation was found concerning hemodynamic parameters. As for diastolic pressure, a significant difference was observed during the incision stage.