Comparative evaluation of anesthetic efficacy of 4% articaine infiltration versus 2% lignocaine inferior alveolar nerve block for extraction of primary mandibular molars A prospective, split-mouth, randomized controlled trial

Context: Control of pain during dental treatment is an essential aspect of pediatric dentistry. Aims: This study was conducted to evaluate and compare the anesthetic efficacy of 4% articaine buccal infiltration with 2% lignocaine inferior alveolar nerve block (IANB) for primary mandibular molar extractions. Settings and Design: The study was a prospective, split-mouth, randomized controlled trial. Methods: Bilateral symmetrical carious primary mandibular molar (n = 92) extractions in 46 healthy children aged 5–10 years were included in this randomized controlled trial. Extraction was performed on one side using 4% of articaine buccal infiltration and on the contralateral side using 2% lignocaine IANB in two subsequent appointments. Pain and behavior were assessed at baseline, during injection and extraction using Wong–Baker Faces Pain Rating Scale, Modified Behavior Pain Scale (MBPS), and Frankl Behavior Rating Scale. Statistical Analysis Used: Values thus obtained were statistically analyzed by one-way analysis of variance test and compared using independent samples test. Results: According to MBPS, the mean value of pain experienced in the form of cry during injection was reported to be more for 2% lignocaine IANB (1.76) as compared to 4% articaine buccal infiltration (1.30), which was statistically significant (P = 0.024). Comparison of behavior depicted showed no statistically significant difference between the groups. Conclusion: Buccal infiltration with 4% articaine can be utilized as an effective alternative to 2% lignocaine IANB for primary mandibular molar extractions.

Comparative evaluation of effect of two relaxation breathing exercises on anxiety during buccal infiltration anesthesia in children aged 6-12 years A randomized clinical study

Background: Dental procedures, especially local anesthetic administration, are a source of great anxiety to children. Diaphragmatic breathing is defined as an efficient integrative body–mind training for dealing with stress and psychosomatic conditions. Pinwheel exercise is also a highly effective technique of “play therapy.” Aim: This study aimed to compare dental anxiety using pinwheel breathing exercise and diaphragmatic breathing exercise during buccal infiltration anesthesia. Methodology: Sixty children in the age group of 6–12 years with Frankel's behavior rating score of 3 who required buccal infiltration local anesthesia were selected. Subjects were divided randomly into two groups, i.e., Group A: children who performed pinwheel breathing exercise and Group B: children who performed diaphragmatic breathing exercise. The level of anxiety of the patients was recorded using an animated emoji scale. The data were analyzed using IBM SPSS version 20 software with paired t-test and Chi-square test. Results: There was a significant reduction in dental anxiety score from score 1 (before the anesthetic procedure) to score 2 (after the anesthetic procedure) in both the groups. On intergroup analysis, children who performed pinwheel breathing exercise (Group A) showed higher values than children who performed deep breathing exercise without pinwheel (Group B) with a t value of 1.42 but was not statistically significant with a P value of 0.161. Conclusion: Pinwheel breathing exercise as well as diaphragmatic breathing exercise proved to be significantly effective in reducing dental anxiety during local anesthesia.