A systematic literature review depicted that upper permanent maxillary teeth can be successfully removed with the exclusive use of 4% Articaine buccal infiltration. Researchers sought to assess the effectiveness of a single buccal infiltration of Articaine for the extraction of upper teeth. For relevant literature search, databases including Ovid SP, Cochrane database, Embase, Scopus, and PubMed were explored in English.

This search was centred on a specific question using MeSH terms [(buccal) and (Articaine) and (infiltration) and (dental)]. Out of the sixteen clinical trials detected, which encompassed 1,339 subjects, 6 of them contrasted the subjective pain experienced during the procedure when using a single buccal infiltration of Articaine to that of Lidocaine. Among these 6 trials, 3 reported a decrease in pain for the Articaine group, while the other 3 reported a higher success rate in tooth extraction for the Articaine group.

Out of the 16 studies analyzed, four of them examined the pain experienced during the procedure when comparing a single buccal infiltration of 4% Articaine to a double infiltration (buccal and palatal/lingual) approach. Among these four studies, two found no significant differences between the two methods, while the other two reported greater success when using palatal and buccal injections.

Additionally, 5/16 studies examined the procedural pain linked with single buccal Articaine to the double buccal and lingual/palatal infiltration of 2% Lidocaine, and they all reported insignificant differences between the two approaches. Lastly, one of the 16 studies compared the subjective pain linked to a single buccal infiltration of 4% Articaine 1:100:000 with that of a single buccal infiltration of 4% Articaine 1:200:000 and found a statistically significant difference between the two.

All these studies reached the consensus that using a 4% Articaine buccal infiltration was promising for the extraction of upper permanent maxillary teeth. However, it remains essential to conduct further research to ascertain whether this method can serve as a viable alternative to the established standard of combining palatal and buccal infiltrations.