Anesthetic Efficacy of Hyaluronidase as an Adjuvant to Lignocaine-Epinephrine in Maxillary Anterior Extractions: A Randomized Controlled Trial

Maxillary anterior tooth extractions are routinely performed procedures under local anesthesia and account for 13.9% of total extractions. The efficacy of local anesthesia is paramount to ensure patient comfort, reduce anxiety, and facilitate a smooth procedure. The infiltration technique is commonly used for anesthesia, with lignocaine (lidocaine) being the anesthetic agent of choice in combination with epinephrine to prolong the anesthetic effect and minimize bleeding. Hyaluronidase is an enzyme that hydrolyses the hyaluronic component of the intercellular ground substance, hence the viscosity of the tissues is reduced permitting a wider spread of the local anesthetic solution.

The porous bone in the anterior maxilla offers an ideal medium for the diffusion of local anesthesia from the buccal to the palatal side of the associated tooth. When used in conjunction with hyaluronidase, this formulation facilitates the adequate distribution of the anesthetic, thereby ensuring sufficient analgesia and obviating the necessity for a painful palatal infiltration.