Transpapillary versus palatal injection technique for maxillary tooth extractions.

Objective: To compare the pain during injection administration and efficacy of transpapillary injection with palatal injection for simple maxillary tooth extractions.

Study Design: Randomized control trial.

Place And Duration Of Study: The oral and maxillofacial surgery department of Armed Forces Institute of Dentistry, Rawalpindi, Pakistan, from July to December 2009.

Methodology: Patients requiring simple extraction in maxilla were randomly divided into two groups each consisting of 100 patients. Group 1 was given conventional palatal injection and served as a control, whereas Group 2 received the transpapillary injection. Two percent Lignocaine with Adrenaline (1:100,000) was used for both groups. Pain during injection and then during the extraction were recorded for both groups using the Visual Analogue Scale and Faces Pain Score Scales on specially designed proformas. The data was analyzed using SPSS version 17.0 and independent t-test was applied to compare pain between both groups. P-value of less than 0.05 was considered to be statistically significant.

Results: Group 1 consisted of 61 males and 39 females with an age ranging from 11-73 years (mean= 39.92 + 14.85 years) while Group 2 consisted of 59 males and 41 females with an age ranging from 10-70 years (mean= 39.31 + 18.53 years). Results of FPS and VAS scores for injection and procedure were analyzed using independent t-test. Difference of scores for pain during injection were found to be significant (p < 0.05) while the scores for the procedure were seen to be statistically insignificant (p > 0.05) showing that transpapillary injection is equally effective for maxillary extractions as palatal injection but with significantly decreased pain during injection.

Conclusion: Transpapillary injection is an easy and effective way of eliminating the pain of palatal injection for maxillary extractions.