A Comparsion Between Articaine Hydrochloride and Buffered Lidocaine Hydrochloride in the Context of Maxillary Permanent Teeth Extraction Using the Buccal Infiltration Technique Only(Clinical Study).

palatal anesthesia remains one of the greatest fears of patients as well as being painful for the patient and bothersome for the dentist .Research is still ongoing to find the best anesthetic agent that achieves the highest success rate of anesthesia and pain control without the need for palatal injection. 2% Lidocaine with sodium bicarbonate the best agent that can achieve the highest success rate across all criteria when using the buccal infiltration technique without the need for palatal anesthesia? The importance of this research lies in finding the best agent that may eliminate the need for painful and annoying palatal injection, therapy alleviating many patient fears, achieving greater patient cooperation during dental procedures in the maxilla, and avoiding multiple palatal anesthesia failures. This research aim to compare the anesthetic efficacy between 4% Articaine and 2% Lidocaine with sodium bicarbonate using the buccal infiltration technique without palatal anesthesia in the context of permanent maxillary first molar extraction, in terms of: 1. Onset time of anesthesia 2. Pain during injection 3. Anesthetic efficacy 4. Duration of anesthetic action The study will be conducted on a sample of patients attending the anesthesia and extraction clinics at the faculty of dentistry, University of Latakia, and the minor oral surgery and dental impaction clinic at Latakia University Hospital. The sample consists of 50 patients with symmetrical upper teeth that are worn down and require extraction. Inclusion Criteria: 1. Systemically healthy patients 2. Patiens age between 18-60 years 3. Patients with no allergy to amide local anesthetics 4. Patients requiring extraction of fully erupted, permanent, single-root teeth Exclusion Criteria 1.Patients younger than 18 years 2.Patients who have taken any analgesic, sedative, antihistamine, anxiolytic, or beta-blocker medications (as the affect anesthetic efficacy assessment) 3.Patiens with sickle cell anemia 4.Patie