Introduction
anxiety, toxicity, Inferior alveolar nerve block, intraoperative pain, tooth, lateral incisors
INFILTRATION, COMPLICATIONS
Profound anesthesia is the most important aspects to achieve successful dentoalveolar extraction. Several anesthetic drugs and techniques are available to attain this goal. The Inferior alveolar nerve block (IANB) is the main technique used to anesthetize the mandibular teeth, but it is more effective in the molar and premolar areas than in the anterior teeth. The IANB has a significant failure rate, ranging from 31% to 41% in mandibular second and first molars to 42%, 38%, and 46% in second and first premolars and canines, respectively, and 81% in lateral incisors [The incomplete anesthesia of IANB in the anterior region may be attributed to the overlapping of the mylohyoid fibers and/ or the contralateral inferior alveolar nerve fibers in this area [According to the anatomical consideration of the mandibular anterior area, where the labial cortical plate of bone is thin enough to the degree that allows infiltration technique to be effective, labial infiltration with an additional lingual injection is required before tooth extraction to achieve profound anesthesia [The main concept in local anesthesia is to achieve profound anesthesia with the least amount of medication and the least number of tissue penetrations to decrease the possibility of complications and the patient’s anxiety [Different local anesthetic agents were introduced into the market and approved for their efficacy. One of them is articaine, which is considered a member of the amide family with a thiophene ring and ester linkage. The increased liposolubility of articaine makes it 1.5 times the potency and 0.6 times the toxicity of lidocaine [Several studies have approved the diffusion power of articaine, where it was concluded that labial infiltration of 4% articaine was enough to extract maxillary teeth without an additional palatal injection [The aim of the present study was to compare the effectiveness of a solitary labial infiltration of 4% articaine with that of 2% lidocaine on intraoperative pain control during the extraction of mandibular anterior teeth without the necessity for additional lingual injection.