Efficacy of infiltrative anesthesia for extraction of endodontically treated mandibular molars: A randomized controlled trial

Background/Aim: In most dental curricula, it has been taught that infiltrative anesthesia (IA) is not sufficient for the extraction of lower molars and that an inferior alveolar nerve block (IANB) is required instead. This study compared the effectiveness of IANB and IA for the extraction of mandibular molars that had previously undergone root canal treatment. Methods: Patients older than 18 years who had a mandibular molar with previously completed root canal treatment were included. Patients who were allergic to local anesthetics, those with severely mobile teeth, those with severe pain due to acute infection, and those using psychotropic drugs were excluded. Sixty subjects were randomly divided into the study (n=30) and control (n=30) groups. An anesthetic solution containing 20 mg/mL lidocaine and 0.0125 mg/mL epinephrine was used. In the study group, only vestibular and lingual IA were used. In the control group, IANB was performed. The teeth were extracted following the standard procedure. The pain experienced during extraction was compared between the study and control groups. Results: There was no significant difference in extraction pain between the two anesthesia techniques (P=0.836). The gender of the patient and whether the tooth to be extracted was a first or second molar did not affect pain (P=0.953 and P=0.900, respectively). Conclusion: Buccal and lingual IA can be used to extract the mandibular molars in certain cases. Teaching dental students that IA can be used instead of IANB in some mandibular molar extractions may provide them with comfort and confidence in clinical practice.