We compared the buccal infiltration of 4%
articaine with 1 : 100,000 or 1 : 200,000
epinephrine without a palatal injection for the extraction of impacted maxillary third molars with chronic
pericoronitis. This prospective, double-blind, controlled clinical trial involved 30 patients between the ages of 15 and 46 years who desired extraction of a partially impacted upper third molar with
pericoronitis. Group 1 (15 patients) received 4%
articaine with 1 : 100,000
epinephrine and group 2 (15 patients) received 4%
articaine with 1 : 200,000
epinephrine by buccal infiltration. None of the patients in group 1 reported
pain, but 3 patients in group 2 reported
pain, which indicated a need for a supplementary palatal injection. The palatal
injections were all successful in eliminating the
pain. Two additional patients in group 2 experienced
pain when the
suture needle penetrated their palatal mucosa. Based on these results, 4%
articaine with 1 : 100,000
epinephrine was found to be more effective for the removal of upper third molars in the presence of
pericoronitis than 4%
articaine hydrochloride with 1 : 200,000
epinephrine when only a buccal infiltration was used.