Adding a distolingual injection to standard nerve blocks for lower wisdom tooth removal

Comparison of Efficacy of Distolingual Infiltration in Conjugation With Conventional Inferior Alveolar Nerve Block to Conventional Inferior Alveolar Nerve Block Alone for Extraction of Mandibular Third Molar

Not applicable Interventional Watim Medical & Dental College · NCT07296926

This will test whether adding a distolingual injection to the usual inferior alveolar and buccal nerve blocks reduces pain during lower wisdom tooth extraction in healthy adults aged 18–45.

Quick facts

PhaseNot applicable
Study typeInterventional
Enrollment120 (estimated)
Ages18 Years to 45 Years
SexAll
SponsorWatim Medical & Dental College Academic / other
Locations1 site (Islamabad)
Trial IDNCT07296926 on ClinicalTrials.gov

What this trial studies

This randomized controlled trial will enroll 120 patients requiring mandibular third molar extraction and randomize them to conventional inferior alveolar and buccal nerve blocks alone or the same blocks plus an additional distolingual infiltration. Pain during mucoperiosteal flap elevation and bone guttering will be recorded on a 0–10 Visual Analogue Scale. The primary comparison is intraoperative pain scores between the two groups to see if the extra infiltration improves anesthesia of the distolingual gingiva. Key exclusions include ASA III or higher, allergy to lignocaine, contraindication to adrenaline, and patients requiring multiple extractions in the same appointment.

Who should consider this trial

Good fit: Ideal candidates are otherwise healthy adults (18–45 years) with an impacted mandibular third molar requiring extraction who are ASA I–II, not allergic to lignocaine, and able to attend the Islamabad clinic.

Not a fit: Patients who are medically compromised (ASA III+), allergic to lignocaine, have contraindications to adrenaline, or require multiple extractions in one appointment are unlikely to qualify or benefit.

Why it matters

Potential benefit: If successful, adding a distolingual infiltration could provide more complete numbness of the distolingual gingiva, reducing intraoperative pain and the need for rescue injections.

How similar studies have performed: Previous clinical reports and small series suggest supplemental distolingual infiltration can improve anesthesia for the distolingual gingiva, but randomized controlled data are limited.

Eligibility criteria

Show full inclusion / exclusion criteria
Inclusion Criteria:

* Healthy individuals

  * Male and female
  * Age 18-45 years
  * Mandibular third molar impaction - all positions
  * Mandibular third molar impaction - all classes

Exclusion Criteria:

* ASA status III and above

  * Patients requiring multiple extractions in the same appointment
  * Allergy to lignocaine
  * Patients in whom adrenaline is contraindicated
  * Medically compromised individuals e.g. poorly controlled diabetes, hypertension

Where this trial is running

Islamabad

Study contacts

How to participate

  1. Review the eligibility criteria above with your treating physician.
  2. Visit the official trial page on ClinicalTrials.gov for the most current contact information and recruitment status.
  3. Contact the listed study coordinator or principal investigator to request pre-screening. Pre-screening is free and never obligates you to enroll.
Conditions Pain
Last reviewed 2026-06-09 by the Find a Trial editorial team. Information on this page is for educational purposes and is not medical advice. Always consult qualified healthcare professionals about clinical trial participation.