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Background The most critical part in management of children in the dental clinic is control of pain and this can be achieved through local anesthesia. When the treatment plan includes extraction of mandibular primary molars, the nerve block technique is the technique of choice for administration of local anesthesia. However, this technique is accompanied with discomfort due to deep penetration of the needle, possibility of nerve injury, hematoma as well as risk of self-inflicted trauma. Therefore, researchers have searched for an alternative technique to facilitate providing painless dental treatment for the child with avoidance of the possible complications of the nerve block technique, and this can be achieved by using a strong and deeply penetrating type of local anesthesia like articaine 4% that can be effective when administered with infiltration technique. The aim of the current study was to compare the efficacy of infiltration anesthesia using alexadricaine 4% and Mepecaine-L 2% in control of pain during extraction of lower 2nd primary molars in children and to compare the change in the heart rate that occurs as a consequence of pain during extraction. A total of 50 children were included in the current study, pain assessment was performed through measuring physiological parameter (pulse rate), subjective parameter (Wong–Baker Facial Pain Scale) and objective parameter (Sound Eye Motor scale). Results showed that there was significant increase in the pulse rate in both groups, while extraction using alexadricaine showed significantly lower pain scores either with Wong–Baker Facial Pain Scale (WBFPS) or with Sound Eye Motor scale (SEM). Conclusions Using a potent anesthetic solution like alexadricaine 4% facilitates extraction of mandibular primary molars, and achieves efficient pain control, with infiltration technique only without any need for the invasive nerve block technique.

Biological evaluation of the efficacy of two different anesthetic solutions in pain control during extraction of mandibular second primary molars