Introduction and objective:

The addition of epinephrine to the anesthetic solution reduces the pH of the solution to a range between 2.9 and 4.4. The acidity of the anesthetic may delay onset and contribute to injection pain.

Objective:

to determine the intensity of pain during a mandibular third molar surgery after using buffered 4% articaine with epinephrine 1:100000 in the inferior alveolar nerve block with buccal infiltration.

Materials and methods:

an observational and descriptive clinical study was performed. The buffered solution was alkalinized with 8.4% sodium bicarbonate with a ratio of 9:1, using a hand-mixing methodology, the sample were patients who required a mandibular third molar surgery. After standardizing the anesthetic technique, it was used the inferior alveolar nerve block followed by buccal infiltration.

Results:

32 patients (20 female - 62.5% and 12 male - 37.5%), with an average age of 21.12 years (mean ± standard deviation : 21.12 ± 3.61) were admitted to the study. When assessing the pain puncture and during the injection, 94% of patients classified it as mild pain according to VAS. When evaluating the latency period, the average time was less than two minutes and the perioral soft tissue anesthesia was 62%. Only a small percentage of patients required complementary anes thesia.

Conclusion:

buffered 4% of articaine with epinephrine in the in ferior alveolar nerve block with buccal infiltration significantly decreased onset time, injection pain and need for complementary anesthesia in third molar surgery.

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