Discussion
pain
MOORE
This study, it was aimed to compare the pain level perceived by the patients during implant surgery with patients who applied two different anesthetic agents (lidocaine and articaine) to obtain IANB on the posterior mandible. According to the results of the study, both during the administration of anesthesia and during the operation with patients who underwent IANB, there was no significant difference in terms of pain perception between the two groups. Although the distance to the mandibular canal was significantly reduced in the articaine group and significantly more releasing incisions were applied to these patients, they did not differentiate patients' perception of pain between the two groups. Besides, the amount of the felt pain did not differ in accordance with the bone type. Both anesthetic agents which were used in IANB that were applied for implant placement in the posterior mandible were equally effective. Considering the factors which can affect the perception of pain, there was not any significant difference between the groups in terms of age, gender, and the number of placed implants. The factors affecting the duration of anesthesia are intrinsic properties of the anesthetic agent and method and are directly affected by the pKa value – a smaller pKa value is associated with a shorter delay. pKa value of 4% articaine solution is 7.8 (When the studies comparing the efficiency of the anesthetic agents are evaluated, it can be seen that there is no consensus in the literature. Since implant surgery is performed with sensitive measurements, IANB anesthesia was preferred in our study as the patient’s pain can affect the surgeon’s performance. In a meta-analysis, it was reported that a 2% lidocaine injection in third molar surgery provided a higher VAS score than a 4% articaine injection (Epinephrine is commonly added to local anesthetic solutions to induce vasoconstriction at the injection site. Addition of epinephrine increases local anesthetic activity by antagonizing the natural vasodilator effects of most local anesthetics, in addition to the vasoconstrictive effects provided by α-1 adrenoceptors. Moore 