Avaliação da anestesia palatina induzida pela técnica vestibular supraperiosteal com articaína a 4% em exodontias de dentes superiores: uma revisão de literatura

Abstract

Maxillary tooth extractions require effective pain control, a procedure that frequently involves palatal infiltration, a technique known to be quite painful. Given this discomfort, this study aims to analyze, through a literature review, the efficacy of a single 4% articaine infiltration using the buccal supraperiosteal technique to achieve palatal anesthesia, eliminating the need for a direct palatal block. The reviewed literature indicates that 4% articaine presents distinct pharmacological properties compared to other amide-type drugs, standing out due to the presence of a thiophene ring and an additional ester chain. These characteristics provide the molecule with greater lipid solubility and superior bone diffusion, allowing the solution to penetrate the maxillary cortical bone and anesthetize the palatal nerve endings from a single buccal infiltration. Study findings demonstrate that the technique is clinically effective for the extraction of permanent and primary maxillary teeth, showing success rates comparable to the conventional technique (buccal and palatal infiltrations) in most cases. Eliminating the palatal injection results in direct benefits, such as reduced pain during anesthetic administration and lower physiological stress, evidenced by greater hemodynamic stability. Despite its high efficacy, the technique has limitations in adult patients and in cases of acute inflammatory processes, situations where supplementary palatal anesthesia may be necessary. On the other hand, in pediatric patients, the efficacy is even higher due to greater bone porosity. Therefore, it is concluded that a single buccal supraperiosteal infiltration with 4% articaine is a safe, effective, and less traumatic alternative for maxillary tooth extractions, and its use should be considered in routine dental practice to increase patient comfort and reduce anxiety.