Inclusion and exclusion criteria
infection
INFECTION
Participants were enrolled from those referred to the clinics of the Faculty of Dentistry, Fayoum University, for the extraction of bilateral mandibular anterior teeth during the period between November 2022 and March 2023. Adult patients, with no gender preference, no relevant medical history, and seeking bilateral, non-surgical extraction of permanent mandibular anterior teeth (either symmetrical or asymmetrical), were included in the study. On the other hand, all patients with highly mobile teeth (Grade 2–3), infection at the needle pathway, sensitivity to lidocaine or articaine local anesthetics, or analgesics use the day before the procedure were excluded.