1
|
Yanık D, Nalbantoğlu AM. Mental foramen and apical foramen: A dangerous anatomical proximity. AUST ENDOD J 2024; 50:352-358. [PMID: 38773860 DOI: 10.1111/aej.12852] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2024] [Accepted: 04/23/2024] [Indexed: 05/24/2024]
Abstract
The study evaluated the spatial position of the mental foramen (MF) using 300 cone-beam computed tomography. The spatial position was analyzed with the horizontal location and relative location (distance between apical foramen and MF). The horizontal location was assessed through three positions (positions 1, 2, and 3). The relative location was determined with the x, y, and x coordinates of the root apex of mandibular premolars and the MF. Student's t-test and chi-square were performed. The most common horizontal location (52%) was position 2, which means between the premolars (p < 0.05). The relative location of the MF to the root apex of the second premolar was closer than the first premolar (p < 0.05). The distance between the root tip of the second premolar and the MF was 5.27 mm, with a minimum value of 1.87 mm. Clinicians should be aware of the possible neural results to the mental nerve of an endodontic infection and the extrusion of irrigation solutions.
Collapse
Affiliation(s)
- Deniz Yanık
- Department of Endodontics, Faculty of Dentistry, Süleyman Demirel University, Isparta, Turkey
| | - Ahmet Mert Nalbantoğlu
- Department of Periodontology, Faculty of Dentistry, Süleyman Demirel University, Isparta, Turkey
| |
Collapse
|
2
|
A Prospective Clinical Study Evaluating the Efficacy of Intra-Ligamentary Anesthetic Solutions in Mandibular Molars Diagnosed as Symptomatic Irreversible Pulpitis with Symptomatic Apical Periodontitis. Healthcare (Basel) 2022; 10:healthcare10081389. [PMID: 35893211 PMCID: PMC9330541 DOI: 10.3390/healthcare10081389] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2022] [Revised: 07/20/2022] [Accepted: 07/22/2022] [Indexed: 11/16/2022] Open
Abstract
Accomplishing painless endodontic treatment, especially in the mandibular molar region, is challenging. Hence, the aim of the study was to compare the efficacy of 2% lidocaine and 4% articaine when used as supplemental intra-ligamentary (IL) anesthesia in mandibular molars having symptomatic irreversible pulpitis with symptomatic apical periodontitis after failed Inferior Alveolar Nerve Block (IANB) injection. In this prospective study, one-hundred and forty-seven adult patients diagnosed with irreversible pulpitis in a mandibular tooth were included who received IANB with 1.8 mL of 2% lidocaine with 1:100,000 epinephrine. Patients who experienced pain were recorded using the Heft–Parker visual analog scale (HP-VAS score ≥ 55 mm) and received supplement intra-ligament injection with either4% articaine or 2% lidocaine with 1:100,000 epinephrine. Supplementary intra-ligament injections resulted in 82.6% and 91.3% of profound anesthesia in the first molar region for 2% lidocaine and 4% articaine, respectively. Similarly, an additional IL injection of articaine success percent (78.9%) in the second molar region was higher than lidocaine (63.1%). The overall success ratio revealed no significant difference in achieving profound anesthesia of either solution. In this study population, there was no difference in the success ratio of anesthesia between 2% lidocaine and 4% articaine when used as supplemental IL injection.
Collapse
|
3
|
Parirokh M, Abbott P. Present status and future directions - Mechanisms and management of local anaesthetic failures. Int Endod J 2022; 55 Suppl 4:951-994. [PMID: 35119117 DOI: 10.1111/iej.13697] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2021] [Revised: 01/30/2022] [Accepted: 02/01/2022] [Indexed: 11/05/2022]
Abstract
Pain control during root canal treatment is of utmost importance for both the patient and the dental practitioner and many studies have investigated ways of overcoming problems with gaining adequate anaesthesia during treatment. The PubMed and Cochrane databases were searched for evidence-based studies regarding local anaesthesia for root canal treatment. Many variables, including premedication, pain during needle insertion, pain on injection, premedication with various types of drugs, volume of anaesthetic solutions, supplemental anaesthetic techniques, and additives to the anaesthetic solutions, may influence pain perception during root canal treatment. Differences between teeth with healthy pulps versus those with irreversible pulpitis should be considered when the effects of variables are interpreted. There are several concerns regarding the methodologies used in studies that have evaluated anaesthesia success rates. There are some conditions that may help to predict a patient's pain during root canal treatment and these conditions could be overcome either by employing methods such as premedication with a non-steroidal anti-inflammatory drug prior to the treatment visit or by using supplementary anaesthetic techniques before or during the treatment. However, authors need to be more careful when reporting details of their studies to reduce concerns regarding their study bias.
Collapse
Affiliation(s)
- Masoud Parirokh
- Endodontology Research Center, Kerman University of Medical Sciences, Kerman, Iran
| | - Paul Abbott
- School of Dentistry, University of Western Australia, Perth, Australia
| |
Collapse
|
4
|
Gupta A, Wadhwa J, Aggarwal V, Mehta N, Abraham D, Aneja K, Singh A. Anesthetic efficacy of supplemental intraligamentary injection in human mandibular teeth with irreversible pulpitis: a systematic review and meta-analysis. J Dent Anesth Pain Med 2022; 22:1-10. [PMID: 35169615 PMCID: PMC8814730 DOI: 10.17245/jdapm.2022.22.1.1] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Revised: 01/04/2022] [Accepted: 01/06/2022] [Indexed: 11/15/2022] Open
Affiliation(s)
- Alpa Gupta
- Department of Conservative Dentistry and Endodontics, Manav Racha Dental College, Faridabad, Haryana, India
| | - Jitesh Wadhwa
- Department of Orthodontics and Dentofacial Orthopedics, Manav Racha Dental College, Faridabad, Haryana, India
| | - Vivek Aggarwal
- Department of Conservative Dentistry and Endodontics, Faculty of Dentistry, Jamia Milia Islamia, New Delhi, India
| | - Namrata Mehta
- Department of Conservative Dentistry and Endodontics, Manav Racha Dental College, Faridabad, Haryana, India
| | - Dax Abraham
- Department of Conservative Dentistry and Endodontics, Manav Racha Dental College, Faridabad, Haryana, India
| | - Kritika Aneja
- Department of Conservative Dentistry and Endodontics, Manav Racha Dental College, Faridabad, Haryana, India
| | - Arundeep Singh
- Department of Conservative Dentistry and Endodontics, Manav Racha Dental College, Faridabad, Haryana, India
| |
Collapse
|
5
|
Gao Q, Henley A, Noël G, Der Khatchadourian Z, Taqi D, Abusamak M, He Z, Grœn S, Taher R, Menassa K, Velly A, Emami E, Mongeau L, Tamimi F. Needle-free Mental Incisive Nerve Block:In vitro, Cadaveric, and Pilot Clinical Studies. Int J Pharm 2021; 609:121197. [PMID: 34666143 DOI: 10.1016/j.ijpharm.2021.121197] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2021] [Revised: 09/29/2021] [Accepted: 10/10/2021] [Indexed: 12/14/2022]
Abstract
The present study aimed to optimize Needle-Free Liquid Jet Injection (NFLJI) for Mental Incisive Nerve Blocks (MINB) and evaluate its clinical safety and feasibility. A MINB protocol was developed and optimized by series of NFLJI experiments in soft tissue phantoms and cadavers, then validated in two pilot Randomized Controlled Trials (RCT). The NFLJI penetration depth was found to be directly proportional to the supply pressure and volume. High-pressure NFLJIs (620 kPa or above) created maximum force and total work significantly greater than needle injections. Low-pressure NFLJIs (413 kPa), however, produced results similar to those of needle injections. Additionally, high-pressure NFLJIs created jet impingement pressure and maximum jet penetration pressure higher than low-pressure NFLJIs. Pilot RCTs revealed that high-pressure NFLJI caused a high risk of discomfort (60%) and paresthesia (20%); meanwhile, low-pressure NFLJI was less likely to cause complications (0%). The preliminary success rates of MINB from cadavers using NFLJIs and needles were 83.3% and 87.5%. In comparison, those from RCTs are 60% and 70%, respectively. To conclude, NFLJI supply pressure can be adjusted to achieve effective MINB with minimal complications. Furthermore, the cadaver study and pilot RCTs confirmed the feasibility for further non-inferiority RCT.
Collapse
Affiliation(s)
- Qiman Gao
- Faculty of Dentistry, McGill University, Montreal, Canada; Department of Mechanical Engineering, McGill University, Montreal, Canada
| | - Anna Henley
- Department of Mechanical Engineering, McGill University, Montreal, Canada
| | - Geoffroy Noël
- Faculty of Dentistry, McGill University, Montreal, Canada; Department of Anatomy and Cell Biology, McGill University, Montreal, Canada
| | | | - Doaa Taqi
- Faculty of Dentistry, McGill University, Montreal, Canada
| | | | - Zixin He
- Department of Mechanical Engineering, McGill University, Montreal, Canada
| | - Swen Grœn
- Department of Mechanical Engineering, McGill University, Montreal, Canada
| | - Rani Taher
- College of Engineering and Technology, American University of the Middle East, Kuwait
| | - Karim Menassa
- Medical International Technology Canada Inc, Montreal, Canada
| | - Ana Velly
- Faculty of Dentistry, McGill University, Montreal, Canada; Lady Davis Institute, Department of Dentistry, SMBD, Jewish General Hospital, Montreal, Canada
| | - Elham Emami
- Faculty of Dentistry, McGill University, Montreal, Canada
| | - Luc Mongeau
- Department of Mechanical Engineering, McGill University, Montreal, Canada.
| | - Faleh Tamimi
- College of Dental Medicine, QU Health, Qatar University, Doha, Qatar.
| |
Collapse
|
6
|
Effectiveness of different anesthetic methods for mandibular posterior teeth with symptomatic irreversible pulpitis: a systematic review and meta-analysis. Clin Oral Investig 2021; 25:6477-6500. [PMID: 34453595 DOI: 10.1007/s00784-021-04145-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2021] [Accepted: 08/12/2021] [Indexed: 10/20/2022]
Abstract
OBJECTIVE This systematic review aimed to assess the effectiveness of anesthetic methods for mandibular posterior teeth with symptomatic irreversible pulpitis, comparing to the inferior alveolar nerve block (IANB) by meta-analysis. MATERIALS AND METHODS Studies were identified from Cochrane Library, Embase, Lilacs, PubMed, Scopus, and Web of Science databases up to May 2021. Randomized clinical trials comparing the anesthetic success rate of IANB and any other alternative anesthetic method were included. The quality of the selected studies was assessed by the Cochrane Risk of Bias 2.0 tool. Meta-analyses using Mantel-Haenszel method and random-effect models were performed to find the pooled estimates of risk ratio (RR) with 95% confidence interval (CI). The quality of evidence was assessed using the Grading of Recommendations, Assessment, Development and Evaluation approach. RESULTS Twenty-two studies were selected, which included fourteen anesthetic methods. Two studies were classified as high risk of bias, five as uncertain risk and fifteen as low risk. Vazirani-Akinosi nerve block (VANB) [RR = 1.27; p = 0.007; 95% CI, 1.07-1.52; I2 = 0%] and intraosseous injection (IOI) [RR = 1.48; p = 0.04; 95% CI, 1.02-2.15; I2 = 46%] had superior effectiveness compared to IANB, with low certainty of evidence, as well as buccal infiltrations associated with IANB (BI + IANB) [RR = 1.84; p = 0.004; 95% CI, 1.22-2.79; I2 = 52%], with very low certainty. CONCLUSION Evidence suggests that buccal infiltrations associated with IANB, VANB, and IOI are more effective than IANB at anesthetizing posterior mandibular teeth with symptomatic irreversible pulpitis. CLINICAL SIGNIFICANCE Alternative primary methods of anesthesia might be indicated for mandibular posterior teeth presenting symptomatic irreversible pulpitis.
Collapse
|
7
|
Jain SD, Carrico CK, Bermanis I, Rehil S. Intraosseous Anesthesia Using Dynamic Navigation Technology. J Endod 2020; 46:1894-1900. [DOI: 10.1016/j.joen.2020.09.001] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2020] [Revised: 09/02/2020] [Accepted: 09/03/2020] [Indexed: 01/30/2023]
|
8
|
Jamil FA, Asmael HM, Al-Jarsha MY. The success of using 2% lidocaine in pain removal during extraction of mandibular premolars: a prospective clinical study. BMC Oral Health 2020; 20:239. [PMID: 32867733 PMCID: PMC7457358 DOI: 10.1186/s12903-020-01228-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Accepted: 08/23/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The purpose of this study was to evaluate the anesthetic effectiveness of a buccal infiltration technique combined with local massage (using 2% lidocaine) in the extraction of mandibular premolars to be utilized as an alternative to the conventional inferior alveolar nerve block. METHODS Patients eligible included any subject with a clinical indication for tooth extraction of the mandibular 1st or 2nd premolars. All patients were anesthetized buccally by local infiltration technique followed by an external pressure applied for 1 min directly over the injection area. In each case, another local injection was given lingually. All operations were started at approximately 5 min after the buccal injection. The collected data included age, gender, pain perception and its intensity during treatment at three checkpoints, apical tenderness, and the type of extraction. Any associated complications or difficulties were also recorded. Then the results were analyzed and interpreted using appropriate statistical tests. The significance level was set at P ≤ 0.05. RESULTS A total of 247 cases (1st premolar, n = 119; 2nd premolar, n = 128), predominantly male, were included. In 95% of study sample, the patients were satisfied with the dental extraction without any pain. However, in 5% of cases, pain was reported at the stage of tooth removal. Apical tenderness was found to be present in 11% of the total cases. Three teeth required surgical removal. Upon analysis, no significant differences in the success rates were detected between the 2 premolar groups or amongst the various age groups. Minor and transient side effects were reported in this study. CONCLUSION The technique is simple and effective as well. It might be considered as an alternative anesthetic injection to the inferior alveolar nerve block for dental extraction of the mandibular premolars.
Collapse
Affiliation(s)
- Firas A Jamil
- Department of Oral & Maxillofacial Surgery, Dental Teaching Hospital, College of Dentistry, University of Baghdad, Bab-Al Moadham, P.O.Box 1417, Baghdad, Iraq.
| | - Huda Moutaz Asmael
- Department of Oral & Maxillofacial Surgery, Dental Teaching Hospital, College of Dentistry, University of Baghdad, Bab-Al Moadham, P.O.Box 1417, Baghdad, Iraq
| | - Mohammed Yahya Al-Jarsha
- Department of Oral & Maxillofacial Surgery, Dental Teaching Hospital, College of Dentistry, University of Baghdad, Bab-Al Moadham, P.O.Box 1417, Baghdad, Iraq
| |
Collapse
|
9
|
Is Bilateral Mental Incisive Nerve Block Better than Unilateral Mental Incisive Nerve Block during the Endodontic Management of Mandibular Incisors with Symptomatic Irreversible Pulpitis? A Prospective Single-blind Randomized Clinical Trial. J Endod 2020; 46:471-474. [DOI: 10.1016/j.joen.2020.01.008] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2019] [Revised: 12/09/2019] [Accepted: 01/07/2020] [Indexed: 11/29/2022]
|
10
|
Nagendrababu V, Aly Ahmed HM, Pulikkotil SJ, Veettil SK, Dharmarajan L, Setzer FC. Anesthetic Efficacy of Gow-Gates, Vazirani-Akinosi, and Mental Incisive Nerve Blocks for Treatment of Symptomatic Irreversible Pulpitis: A Systematic Review and Meta-analysis with Trial Sequential Analysis. J Endod 2020; 45:1175-1183.e3. [PMID: 31551112 DOI: 10.1016/j.joen.2019.06.008] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2019] [Revised: 06/15/2019] [Accepted: 06/24/2019] [Indexed: 01/20/2023]
Abstract
INTRODUCTION This systematic review compared the anesthetic efficacy between Gow-Gates (GG), Vazirani-Akinosi (VA), and mental incisive (MI) nerve blocks (NBs) with inferior alveolar nerve blocks (IANBs) in mandibular teeth with irreversible pulpitis using meta-analysis and trial sequential analysis (TSA). METHODS Studies were identified from 4 electronic databases up to June 2019. Randomized clinical trials (RCTs) comparing the anesthetic success rate of GG, VA, and MI NBs with IANBs in mandibular premolars and molars with irreversible pulpitis were included. The quality of selected RCTs was appraised using the revised Cochrane risk of bias tool. Random-effects meta-analyses of risk ratio (RR) and 95% confidence intervals (CIs) were calculated, and random errors were evaluated by TSA. The quality of evidence was assessed using the Grading of Recommendations, Assessment, Development and Evaluation approach. RESULTS Five RCTs were included; 2 of them were classified as low risk of bias. No significant difference was observed in the anesthesia success rate compared between GG and IA NBs (RR = 1.10; 95% CI, 0.82-1.48; I2 = 0%). Similarly, no difference was evident between MINB and IANB (RR = 1.15; 95% CI, 0.97-1.36; I2 = 0%). Overall, the cumulative success rates for the 3 anesthetic techniques were low. TSA showed a lack of firm evidence for the results of the meta-analysis between GG NB and IANB. The Grading of Recommendations, Assessment, Development and Evaluation approach evaluation showed that the evidence was of moderate quality for GG NB and IANB compared with low quality for MI and IA NBs. Because only 1 study was available comparing VA NB and IANB, a meta-analysis was not performed. The adverse effect associated with MI NB was swelling, whereas it was prolonged numbness for IANB. CONCLUSIONS GG NB and IANB showed similar anesthetic efficacy compared with IANB in mandibular teeth with irreversible pulpitis. However, the success rates for each technique indicate the need for supplemental anesthesia. Further well-designed RCTs evaluating different anesthetic techniques with and without supplemental injection are required to provide stronger evidence.
Collapse
Affiliation(s)
- Venkateshbabu Nagendrababu
- Division of Clinical Dentistry, School of Dentistry, International Medical University, Kuala Lumpur, Malaysia.
| | - Hany Mohamed Aly Ahmed
- Department of Restorative Dentistry, Faculty of Dentistry, University of Malaya, Kuala Lumpur, Malaysia
| | - Shaju Jacob Pulikkotil
- Division of Clinical Dentistry, School of Dentistry, International Medical University, Kuala Lumpur, Malaysia
| | - Sajesh K Veettil
- School of Pharmacy, International Medical University, Kuala Lumpur, Malaysia
| | - Lalli Dharmarajan
- School of Postgraduate Studies, International Medical University, Kuala Lumpur, Malaysia
| | - Frank C Setzer
- Department of Endodontics, School of Dental Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| |
Collapse
|
11
|
Success Rate of 3 Injection Methods with Articaine for Mandibular First Molars with Symptomatic Irreversible Pulpitis: A CONSORT Randomized Double-blind Clinical Trial. J Endod 2018; 44:1462-1466. [DOI: 10.1016/j.joen.2018.07.010] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2018] [Revised: 07/03/2018] [Accepted: 07/10/2018] [Indexed: 11/20/2022]
|
12
|
Anesthetic efficacy of mental/incisive nerve block compared to inferior alveolar nerve block using 4% articaine in mandibular premolars with symptomatic irreversible pulpitis: a randomized clinical trial. Clin Oral Investig 2018; 23:839-845. [DOI: 10.1007/s00784-018-2500-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2018] [Accepted: 05/29/2018] [Indexed: 10/14/2022]
|
13
|
Hafez O, Ackerman RS, Evans T, Patel SY, Padalia DM. Mental Nerve Blocks for Lip Brachytherapy: A Case Report. A A Pract 2018; 10:265-266. [PMID: 29757796 DOI: 10.1213/xaa.0000000000000681] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
High dose rate interstitial brachytherapy is a commonly performed procedure for carcinoma of the lower lip. Placement of the brachytherapy catheters can be painful and may require monitored anesthesia care or general anesthesia. We present the use of bilateral mental nerve blocks with minimal sedation to facilitate placement of brachytherapy catheters.
Collapse
Affiliation(s)
- Osama Hafez
- From the Department of Anesthesiology, H. Lee Moffitt Cancer Center, Tampa, Florida
| | - Robert S Ackerman
- University of South Florida, Morsani College of Medicine, Tampa, Florida
| | - Trip Evans
- From the Department of Anesthesiology, H. Lee Moffitt Cancer Center, Tampa, Florida
| | - Sephalie Y Patel
- From the Department of Anesthesiology, H. Lee Moffitt Cancer Center, Tampa, Florida
| | - Devang M Padalia
- From the Department of Anesthesiology, H. Lee Moffitt Cancer Center, Tampa, Florida
| |
Collapse
|
14
|
Sakhaeimanesh V, Khazaei S, Kaviani N, Saatchi M, Shafiei M, Khademi A. Anesthetic Efficacy of Articaine and Ketamine for Inferior Alveolar Nerve Block in Symptomatic Irreversible Pulpitis: A Prospective Randomized Double-Blind Study. IRANIAN ENDODONTIC JOURNAL 2017; 12:449-453. [PMID: 29225640 PMCID: PMC5722109 DOI: 10.22037/iej.v12i4.16224] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Introduction The aim of this prospective, randomized, double-blind study was to investigate the effect of articaine combined with ketamine on the success rate of inferior alveolar nerve block (IANB) in posterior mandible teeth with symptomatic irreversible pulpitis. Methods and Materials Forty two adult patients with diagnosis of symptomatic irreversible pulpitis of a mandibular posterior tooth were selected. The patients received two cartridges of either containing 3.2 mL 4% articaine with epinephrine 1:200000 and 0.4 mL 50 mg/mL ketamine hydrochloride (A-ketamine group) or 3.2 mL 4% articaine with epinephrine 1:200000 and 0.4 mL normal saline (A-saline group) using conventional IANB injections. Access cavity preparation started 15 min after injection. Lip numbness was required for all the patients. Success was considered as no or mild pain on the basis of Heft-Parker visual analog scale recordings upon access cavity preparation or initial instrumentation. Data were analyzed by independent student t, Mann-Whitney and Chi-square tests. Results The success rates were 55% and 42.9% for A-ketamine and A-saline group, respectively, with no significant differences between the two groups (P=0.437). Conclusion Adding 0.4 mL 50 mg/mL ketamine hydrochloride to the articaine local anesthetic did not increase the efficacy of IANB for posterior mandibular teeth with symptomatic irreversible pulpitis.
Collapse
Affiliation(s)
- Vahid Sakhaeimanesh
- Department of Endodontics, Dental Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Saber Khazaei
- Department of Endodontics, Dental Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Naser Kaviani
- Department of Oral and Maxillofacial Surgery, Dental Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Masoud Saatchi
- Department of Endodontics, Dental Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Maryam Shafiei
- Department of Endodontics, Dental Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Abbasali Khademi
- Department of Endodontics, Dental Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| |
Collapse
|