| Abstrakt: |
Buffering of Local anaesthesia (LA) has been suggested as a mechanism to improve injection comfort and hasten the onset of anaesthesia. Aim: This study aimed to evaluate the effectiveness of buffered LA in the extraction of maxillary premolars and molars. Materials and Methods: This randomized controlled study included 100 patients who were indicated for extraction of maxillary posterior teeth, they were randomly divided into two groups; a study group that received infiltration of buffered 2% lidocaine hydrochloride with 1:80,000 epinephrine LA, and a control group that received non‐buffered 2% lidocaine hydrochloride with 1:80,000 epinephrine LA. The buffering was performed using the Onset® LA buffering system (Onpharma®). The outcome variables included the pain during injection buccally and palatally assessed by pain Numerical rating scale, the onset of anaesthesia, the volume of local anaesthesia used, and the patient satisfaction for the whole procedure. Results: There were statistically significant differences in pain during injection buccally and palatally in favour of the study group (p < 0.0001) with a large effect size for the palatal injection and moderate effect size for the buccal injection. The onset of anaesthesia on the buccal and palatal sides was significantly faster in the study group (p values 0.02 and 0.01, respectively). There was a non‐significant difference between the groups with respect to the volume of anaesthesia (p = 0.07). The patients in the study group reported a significantly higher satisfaction score (p < 0.0001). Conclusions: Buffered LA significantly reduced the onset of action of anaesthesia and pain during injection, especially on the palatal side, and resulted in better satisfaction with the extraction procedure. Clinical relevance: Local anaesthesia is essential to control pain in dental extraction, but it is perceived as a painful procedure, one of the methods to reduce pain during injection of local anaesthesia is by buffering with sodium bicarbonate which also hastens the onset of its action. The rationale of this study is that buffering of local anaesthesia immediately before injection using the Onset® buffering system is a simple, convenient, and predictable chair‐side method that will result in less pain during injection, rapid onset of action, and better patient satisfaction. [ABSTRACT FROM AUTHOR] |
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