Infiltration anesthesia for extraction of the mandibular molars.

Profound anesthesia for mandibular molars by buccal infiltration has been tried in recent years, with promising results. This prospective, randomized, single-blinded, crossover study investigated the clinical anesthetic efficacy obtained with 1:100,000 epinephrine plus 4% articaine (A100) 1.8 versus 3.6 mL as mandibular first molar buccal infiltration during removal of impacted lower third molars. Thirty adult patients underwent removal of symmetrically positioned impacted lower third molars in 2 separate appointments. The patients randomly received mandibular buccal first molar infiltration of A100 1.8 or 3.6 mL during surgery. For assessment of anesthetic efficacy, any pain during surgery was rated using the visual analog scale. Also, the onset, duration, and total amount of anesthetic used were recorded. Compared with the 1.8-mL volume of A100, the 3.6-mL volume showed a statistically higher success rate (93% vs 56%). Infiltration in the buccal vestibule opposite the mandibular first molar by A100 3.6 mL may be a good option for extraction of mandibular third molars, with supplemental lingual anesthesia.