Comparison between infiltration and inferior alveolar nerve block anesthesia in extraction of non-vital mandibular posterior teeth (prospective clinical study)

* Department of Oral and Maxillofacial Surgery, College of Dentistry, Hawler Medical University, Erbil, Iraq. Introduction deep and invasive needle penetration; parasthesia; muscle trismus; hematoma formation; high incidence of positive aspiration; and difficulty in hemostasis in patients with bleeding disorders. Infiltration anesthesia has been avoided in the mandibular molar regions because of dens bone that does not allow adequate diffusion of the anesthetic solution to the bone. To the best of our knowledge, no previous study investigated the effectiveness of infiltration anesthesia in dental extraction of mandibular posterior teeth, most of the studies used infiltration anesthesia as an alternative to block anesthesia for mandibular posterior teeth in placing dental implants. This study focused on the effectiveness of mandibular infiltration compared with inferior alveolar nerve block in the extraction of non vital mandibular posterior teeth. Background and objective: Infiltration anesthesia for the posterior region of the mandible has been routinely avoided because of its questionable effectiveness related to the dense cortical bone of the mandible. The aim of this study was to evaluate the effectiveness of infiltration anesthetic technique on mandibular posterior non-vital teeth. Methods: Forty four patients aged between 13and 73 years who attended the Department of Oral and Maxillofacial Surgery in the College of Dentistry, Hawler Medical University for extraction of posterior non vital tooth were included in this study. For the infiltration anesthetic technique, patient’s approval was taken. The patients were equally divided into two groups. Group (1) received 0.6 ml out of 1.8 ml of 2% lidocaine with 1:80000 adrenaline injection bucally and the same amount infiltration lingually opposite the intended tooth. Group (2) received 1.5 ml out of 1.8 ml of 2% lidocaine with 1:80000 and the remaining 0.3 ml was injected for long buccal nerve anesthesia. Results: In group (1), 68.2% had no pain during extraction, showed statistically highly significant difference (P = 009). Gender showed no significant difference. In group (2), 100 % of the patients had no pain during extraction. Conclusion: Infiltration anesthesia for non-vital mandibular molars is effective as a substitute for inferior alveolar block technique.