Objective This study was to test the feasibility of permanent maxillary tooth removal using articaine without a second palatal injection. Methods Of 104 patients, 38 patients had bilateral extraction and 66 patients had unilateral extraction of maxillary tooth. In the test group, 1.7 mL articaine with 1∶100 000 epinephrine was injected into the buccal vestibule of the tooth and the tooth were extracted after 5 minutes. In the control group, the patients were subjected to both palatal injection with 2% lidocaine hydrochloride and buccal injection with articaine. All patients completed visual analog scales（VAS） after extraction. Results The achievement ratio of permanent maxillary tooth anesthesia of test group was 96.2%. The achievement ratio of permanent maxillary tooth anesthesia of control group was 97.1%. There was no statistical significance between achievement ratio of test group and control group（P>0.05）. Conclusion Permanent maxillary tooth removal without palatal injection is possible by articaine injection to the buccal vestibule of the tooth.
