Infiltrative Anesthesia With Lidocaine Can Replace the Inferior Alveolar Nerve Block in Extraction of Devitalized Mandibular Molar Teeth

Abstract Purpose: In dental education, it has been traditionally emphasized that inferior alveolar nerve block (IANB) is essential for extracting lower molars. However, it is also known that dental implants can be placed in the same region using only infiltrative anaesthesia (IA). We hypothesize that there is no difference in anesthesia requirements between the extraction of a devitalized tooth and the placement of an implant. Therefore, we aimed to compare the effectiveness of IANB and IA in the extraction of devitalized mandibular molars. Methods: This study was a prospective, randomized, and non-blinded clinical trial. Sixty patients over the age of 18, each with a mandibular first or second molar that had previously undergone root canal treatment, were included. They were randomly assigned to either the study or control groups. An anesthetic solution containing lidocaine and epinephrine was employed. In the study group, only vestibular and lingual IA were used, while the control group received IANB. Pain experienced during the injection and extraction was recorded separately. Statistical analyses included the Mann-Whitney U test and Spearman correlation analysis, with significance set at p<0.05. Results: There was no significant difference between the two anaesthesia techniques in terms of injection or extraction pain (p>0.05). Gender and whether the tooth was a first or second molar did not influence the pain experienced. Conclusions: Mandibular molars that have previously undergone root canal treatment can be extracted using buccal and lingual IA instead of IANB. This approach may also apply to other devitalized mandibular molars.