This study Is designed as a prospective randomized, single-blinded clinical trial. To evaluate The anesthetic efficacy of articaine as a buccal Injection for maxillary premolar teeth extraction, compared to lidocaine as a buccal and palatal injection.

In the current study, the sample size (200) patients were distributed into two groups, group (A), 100 patients extracted upper premolar teeth by using 1.8 mL cartridges of 4% articaine hydrochloride with 1:100,000 epinephrine (Artheek, Colombia) as a buccal injection without palatal injection, and Group (B), 100 patients were removed upper premolar teeth by using Injectable local anesthetic agents included; 1.8 mL cartridges of 2% lidocaine hydrochloride with 1:80,000 epinephrine (Huons, Korea) as a buccal and palatal injection, the pain assessment after extraction was assessed by using (vas) visual analog scale, comparison between the outcomes by the two groups were evaluated, according to many variables (age, gender, extracted tooth, type of anesthesia, extraction duration).

Inclusion Criteria:

1. Patients ≥ 16 years old, including both genders.
2. Patients indicated for extraction of one of the maxillary premolar's teeth.

Exclusion Criteria:

1. Patients who were allergic to the local anesthetic agents used in this study.
2. Patients who presented with acute periapical infections.
3. Patients who required surgical extraction that entails flap reflection and bone removal.
4. Pregnant patients.
5. Patients with uncontrolled systemic diseases.
6. Patients are taking medications affecting pain assessment, like opioids.