Comparative evaluation of the influence of the palatal root length on the efficacy of maxillary buccal infiltration by open and closed mouth technique: a randomized control trial.

Background: Maxillary molars are commonly anesthetized via buccal infiltration. A patient's mouth opening during maxillary buccal infiltration can influence dental treatment. Hence, this study aimed to evaluate and compare the influence of palatal root length on the efficacy of 2% lidocaine in 1:80000 adrenaline for maxillary buccal infiltration (MBI) between the open- and closed-mouth techniques. Methods: Sixty patients were selected based on inclusion and exclusion criteria. The intensity of pre-operative pain was measured using a visual analog scale (VAS). Samples were randomly divided using the chit method, with odd numbers in group 1 and multiples of two in group 2. In group 1 (n = 30), MBI was performed using the open-mouth technique, and in group 2 (n = 30), MBI was performed using the closed-mouth technique. Five minutes after injection, electric pulp testing was performed. For a negative response, patients were asked to rate their level of discomfort using the VAS. The palatal root length was measured after opening the access point using an apex locator. The groups were evaluated for patient discomfort using VAS. Results: Results were analyzed using the Wilcoxon signed-rank test and Mann-Whitney test. A comparison of MBI between the open- and closed-mouth techniques showed that the closed-mouth technique had significantly better efficacy than the open-mouth technique when the palatal root length was greater than 19 mm (P < 0.05). Conclusion: Within the limitations of the study, when the palatal root length was greater than 19 mm, the closed-mouth technique resulted in less patient discomfort, improved visibility, and better needle penetration.