Evaluation of Healing Process and Blood Sugar Level Following Local Anesthetic Infiltration with and Without Vasoconstrictor for Extraction of Maxillary Teeth in Diabetic Patients: Double Blind Randomized Controlled Clinical Trial

Background: Dental extractions are routinely performed in dental offices, and the local anesthetics most frequently employed are combined with vasoconstrictors, which have undeniable benefits. Vasoconstrictors boost the quality of anesthesia, lessen toxic effects, reduce the concentration required, and reduce blood loss during surgical operations. Objective: The aim of the current study was to evaluate healing of the extraction socket and the glycemic levels before, and after injection of local anesthesia with and without vasoconstrictor in diabetic patients.
Patients and methods: A total of 40 patients with controlled diabetes requiring dental extraction were randomly and equally allocated to either group A (anesthetized with Mepivacaine hydrochloride 30 mg (3%) without vasoconstrictor) or group B (anesthetized with Mepivacaine hydrochloride 20 mg (2%) with vasoconstrictor Levonordefrin hydrochloride 0.06 mg). The involved tooth was extracted in an atraumatic manner. Blood glucose level was recorded prior to and 30 minutes following extraction and healing of extraction socket was assessed at 24 hours, 4-, 7-, 14- and 21-days using Landry wound healing index. Results: Regarding healing scores results showed no statistically significant difference between groups A and B at 24 hour and 21-day period, however group A showed a statistically significant faster healing than group B at 4, 7, 14 days period with P values 0.091, 0.027 and 0.035, respectively. While results for blood glucose level showed statistically significant difference in the same group before and after local anesthesia injection (P>0.001); moreover, after administration of local anesthesia group B showed statistically significant higher blood glucose level than did group A (P=0.04).
Conclusion: Vasoconstrictor present in local anesthetic elevate blood glucose level and may retard extraction socket wound healing with in the first 2 weeks following extraction; however, it is still safe to use local anesthesia with vasoconstrictor with controlled diabetic patients.