Intervention steps
tooth
INFILTRATION
For all the participant in this study, local anesthesia was delivered by one surgeon, and the extraction was completed by another surgeon. The surgeon who performed the extraction was not aware of the utilized local anesthetic agent. A standardized labial supra-periosteal infiltration technique was used for both groups by using a 27-gauge short needle that was inserted at a 45° angle with the long axis of the tooth and the injection rate was kept at 60 s. The study group received a single labial infiltration of 1.7ml of 4% articaine HCL with 1:100,000 epinephrine (Septocaine, Septodont, New Castle, Del.). The control group received a single labial infiltration of 1.8 ml of 2% lidocaine HCL with 1:100,000 epinephrine (Xylocaine, AstraZeneca, York, Pa.). The extraction was performed five minutes after the local anesthetic injection.