Articaine use does not routinely eliminate the need for palatal injections for primary maxillary molar extractions: a randomized cross-over clinical trial

Purpose The aim of this study was to compare single buccal infiltration of 4% articaine versus routine buccal and palatal injections of 2% lidocaine during bilateral extraction of maxillary primary molars. Methods Thirty healthy children aged 6–9 years old requiring bilateral extraction of maxillary primary molars were enrolled into the trial. Randomization was performed in two steps. Routine buccal and palatal infiltrations were administered using 2% lidocaine in the control side. Four percent articaine was used for single buccal infiltration in the intervention side. WBFP scale (Wong-Baker FACES Pain scale) was employed for subjective assessment of pain. For objective evaluation of pain, FLACC scale (Face, Legs, Activity, Cry, Consolability) and physiological parameters of blood pressure and pulse rate were recorded. Results Analyses did not show any significant differences in blood pressure, pulse rate, and FLACC scale between groups ( P value > 0.05). However, statistically lower WBFP scores were observed in articaine group as compared to lidocaine group ( P value