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Fauziya D, Anantanarayanan P, Shankar DP. Effectiveness and Distribution of Anesthesia for a Modified Extra Oral Maxillo-Mandibular Nerve Block for Dento-Alveolar Procedures: A Prospective Cohort Study. J Maxillofac Oral Surg 2024; 23:561-567. [PMID: 38911425 PMCID: PMC11189874 DOI: 10.1007/s12663-022-01755-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2020] [Accepted: 06/03/2022] [Indexed: 10/17/2022] Open
Abstract
Aim To evaluate the effectiveness of a modified maxillo-mandibular nerve block technique that includes anesthetizing the maxillary and mandibular nerve with single injection. Materials and Methods A prospective, clinical cohort study was carried out including patients who presented for surgical removal of maxillary and mandibular third molars. All patients were administered maxilla-mandibular nerve block through a single injection on one side. Three clinical neurosensory tests were used for mapping the area of anesthesia and to assess and grade objectively the effect of the block. Light touch (LT), two-point discrimination (TPD), pin prick (PP) and Electric pulp testing (EPT) were used for all branches of maxillary and mandibular nerve. An extra oral mapping chart for depth of anesthesia was maintained for each patient to categorize the grades as nil, intermediate and highly anesthetized areas. Results 62 patients were assessed in the study. EPT showed greater depth of pulpal anesthesia in posterior teeth than the anterior in both maxilla and mandible. PP and TPD tests also showed that the anesthetic effect varied between posterior divisions demonstrating extreme anesthesia compared to the anterior divisions. Conclusion This technique was found to be successful for surgical extractions involving the maxillary and mandibular regions. Supplementary Information The online version contains supplementary material available at 10.1007/s12663-022-01755-w.
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Affiliation(s)
- Dastagir Fauziya
- Department of Oral & Maxillofacial Surgery, Meenakshiammal Dental College & Hospital, Alappakkam Main Road, Madhuravoyal, Chennai 600095 India
| | - Parameswaran Anantanarayanan
- Department of Oral & Maxillofacial Surgery, Meenakshiammal Dental College & Hospital, Alappakkam Main Road, Madhuravoyal, Chennai 600095 India
| | - D. Prabhu Shankar
- Department of Oral & Maxillofacial Surgery, Meenakshiammal Dental College & Hospital, Alappakkam Main Road, Madhuravoyal, Chennai 600095 India
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The effect of pre-anesthesia with a needle-free system versus topical anesthesia on injection pain of the inferior alveolar nerve block: a randomized clinical trial. Clin Oral Investig 2020; 24:4355-4361. [PMID: 32382924 DOI: 10.1007/s00784-020-03301-9] [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: 10/21/2019] [Accepted: 04/17/2020] [Indexed: 10/24/2022]
Abstract
OBJECTIVE The aim of this study was to compare the effectiveness of pain control between a needle-free system and topical anesthesia applied prior to inferior alveolar nerve block (IANB). MATERIALS AND METHODS The present study was designed as a randomized controlled cross-over clinical study on 60 children (aged 6 to 12 years) requiring dental treatment with IANB in bilateral mandibular molars. As pre-anesthesia, topical anesthesia (TA) was applied on one side and the Comfort-in™ injection system (CIS) on the other side in two separate sessions before IANB. The injection pain during IANB, at both the needle insertion and solution deposition phases, was analyzed using the Wong-Baker Faces Pain Rating Scale (PRS) and the Face, Legs, Activity, Cry, Consolability Scale (FLACC). The data were analyzed using the Wilcoxon signed-rank test, Spearman correlation, and Mann-Whitney U test. RESULTS There were statistically significant differences between TA and CIS in subjective and objective pain evaluations during both the needle insertion and solution deposition. The use of a needle-free system in pre-anesthesia yielded a significant decrease in subjective and objective pain scores (p < 0.001). No statistical difference was found between TA and CIS in terms of patient preference, but patient preference for CIS was significantly higher in older patients (p < 0.01). CONCLUSIONS It was determined that the use of a needle-free system in pre-anesthesia yielded a decrease in injection pain of IANB. CLINICAL RELEVANCE Pediatric dentists should be aware of the new injection system in order to decrease the level of injection pain.
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Effectiveness of Articaine Buccal Infiltration Anesthesia for Mandibular Premolar Extraction: A Randomized, Double-Blind, Placebo-Controlled Clinical Trial. J Oral Maxillofac Surg 2019; 77:1784-1789. [DOI: 10.1016/j.joms.2019.03.033] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2019] [Revised: 03/19/2019] [Accepted: 03/23/2019] [Indexed: 11/17/2022]
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Fowler S, Crowley C, Drum M, Reader A, Nusstein J, Beck M. Inferior Alveolar Nerve Block Injection Pain Using a Computer-Controlled Local Anesthetic Device (CCLAD): A Prospective, Randomized Study. Anesth Prog 2019; 65:231-236. [PMID: 30715932 DOI: 10.2344/anpr-65-03-11] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
There is evidence that the Computer-Controlled Local Anesthetic Device (CCLAD) decreases the pain of oral injections. The purpose of this study was to evaluate injection pain of the inferior alveolar nerve block (IANB) using the CCLAD in an upright position versus a supine position. Additionally, we evaluated solution deposition pain with the CCLAD when compared to previous studies using a traditional syringe. One hundred ten asymptomatic subjects were randomly given IANBs using 2% lidocaine with 1:100,000 epinephrine while in an upright sitting position and supine position, at 2 different appointments, spaced at least 2 weeks apart. Each subject rated the pain for needle insertion, needle placement, and solution deposition on a Heft-Parker visual analogue scale. Pain ratings were compared between the upright and supine positions using a repeated-measures analysis of variance with post hoc testing using the Tukey-Kramer procedure. Moderate to severe pain was reported by 10% to 13% of the patients for needle insertion, 74% to 75% for full needle placement, and 8% to 10% for solution deposition. There was no significant difference between groups for phases of the injection. When comparing the injection phases within the groups, the needle placement phase of the injection was statistically more painful than both the needle insertion phase and solution deposition phase ( p = .0001). Using the CCLAD, IANB injection pain of the supine and upright positions was not statistically different. Needle placement was the most painful phase of the injection. Solution deposition pain was less with the CCLAD when compared to other studies of the IANB using a traditional syringe.
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Affiliation(s)
- Sara Fowler
- Assistant Professor and Predoctoral Director, Division of Endodontics, The Ohio State University, Columbus
| | - Chase Crowley
- Former Graduate Student in Endodontics, The Ohio State University, Columbus
| | - Melissa Drum
- Associate Professor and Graduate Program Director, Division of Endodontics, The Ohio State University, Columbus
| | - Al Reader
- Professor, Division of Endodontics, The Ohio State University, Columbus
| | - John Nusstein
- Professor and Chair, Division of Endodontics, The Ohio State University, Columbus
| | - Mike Beck
- Emeritus Associate Professor, Division of Biosciences, The Ohio State University, Columbus
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Farhad A, Razavian H, Shafiee M. Effect of intraosseous injection versus inferior alveolar nerve block as primary pulpal anaesthesia of mandibular posterior teeth with symptomatic irreversible pulpitis: a prospective randomized clinical trial. Acta Odontol Scand 2018; 76:442-447. [PMID: 29374995 DOI: 10.1080/00016357.2018.1428826] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
OBJECTIVE This study sought to assess the success rate, effect on blood pressure, and pain of intraosseous injection (IO) and inferior alveolar nerve block (IANB) for pulpal anaesthesia of mandibular posterior teeth with symptomatic irreversible pulpitis as the primary anaesthetic technique. MATERIALS AND METHODS This randomized clinical trial (IRCT2013022712634N1) was conducted on 60 patients between 18 and 65 years suffering from symptomatic irreversible pulpitis of a mandibular posterior tooth. Patients were randomly divided into two groups. Group one received IO while group two received IANB with 3% mepivacaine. After anaesthetic injection, success rate of pulpal anaesthesia was assessed by pulp testing in the two groups. Systolic and diastolic blood pressures of patients were compared before and after the anaesthetic injections. Level of pain during injection was scored using a visual analogue scale. The data were analyzed using SPSS version 20, t-test and chi square test at p = .05 level of significance. RESULTS Success rate of IO (56.7%) was significantly higher than that of IANB (23.3%) (p = .008). There was no significant difference in pain during anaesthetic injection (p = .304) or change in systolic (p = .80) and diastolic (p = .28) blood pressures following injection between the two techniques. CONCLUSIONS IO had a higher success rate than IANB for pulpal anaesthesia of mandibular posterior teeth with symptomatic irreversible pulpitis. Neither technique provided profound pulpal anaesthesia.
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Affiliation(s)
- Alireza Farhad
- Dental Research Center, Department of Endodontics, School of Dentistry, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Hamid Razavian
- Dental Research Center, Department of Endodontics, School of Dentistry, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Maryam Shafiee
- Department of Endodontics, School of Dentistry, Isfahan University of Medical Sciences, Isfahan, Iran
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Aggarwal V, Singla M, Miglani S. Effect of relative head position on the anesthetic efficacy of inferior alveolar nerve block during endodontic treatment of patients with irreversible pulpitis. J Dent Anesth Pain Med 2018; 18:41-46. [PMID: 29556558 PMCID: PMC5858008 DOI: 10.17245/jdapm.2018.18.1.41] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2017] [Revised: 01/28/2018] [Accepted: 02/01/2018] [Indexed: 11/23/2022] Open
Abstract
Background The purpose of this prospective randomized single-blind clinical trial was to evaluate the effect of tilting the head on the anesthetic efficacy of inferior alveolar nerve block (IANB) in patients with symptomatic irreversible pulpitis. Methods Ninety-two patients were divided into two groups: the first group received IANB and the head was tilted in the direction of the block for 15 min, whereas the second group received IANB and the head was tilted to the opposite side. Access cavity preparation was initiated after 15 min. Success was defined as no pain or faint/weak/mild pain during endodontic access preparation and instrumentation. The anesthetic success rates were analyzed by Pearson chi-square test at 5% significance levels. Results The same side position and opposite side position yielded 41% and 30% anesthetic success rates, respectively; there was no significant difference between the two sides. Conclusions Relative head position has no effect on the anesthetic success rate of IANB.
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Affiliation(s)
- Vivek Aggarwal
- Department of Conservative Dentistry & Endodontics, Faculty of Dentistry, Jamia Millia Islamia, New Delhi, India
| | - Mamta Singla
- Department of Conservative Dentistry & Endodontics, SGT Dental College, Gurgaon, India
| | - Sanjay Miglani
- Department of Conservative Dentistry & Endodontics, Faculty of Dentistry, Jamia Millia Islamia, New Delhi, India
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Zhang W, Dai YB, Wan PC, Xu DD, Guo Y, Li Z. Relationship between post-extraction pain and acute pulpitis: a randomised trial using third molars. Int Dent J 2016; 66:325-329. [DOI: 10.1111/idj.12249] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
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ARAGÃO JMRD, AMORIM KDS, CUNHA RSD, GROPPO FC, SOUZA LMDA. Comparação do nível álgico no bloqueio do nervo alveolar inferior através de duas técnicas distintas. REVISTA DE ODONTOLOGIA DA UNESP 2016. [DOI: 10.1590/1807-2577.04216] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Resumo Introdução O bloqueio do nervo alveolar inferior está entre as anestesias mais utilizadas e importantes da Odontologia; porém, não há estudos que comparem a anestesia eletrônica (Morpheus) e a anestesia tradicional manual, utilizando a seringa Carpule. Objetivo Avaliar comparativamente dois sistemas de anestesia com relação à sensibilidade dolorosa durante e após a anestesia, com a administração de lidocaína 2% associada à epinefrina 1:100.000, na técnica anestésica para o nervo alveolar inferior. Material e método Este ensaio clínico foi executado de modo randomizado, cruzado e duplamente cego, envolvendo 30 voluntários, que necessitavam de tratamento odontológico e que se submeteram ao bloqueio do nervo alveolar inferior, utilizando a seringa tipo Carpule na primeira sessão e o injetor de velocidade controlada Morpheus, o qual foi realizado em duas sessões, com intervalo de pelo menos duas semanas entre cada sessão. Ao final de cada sessão, foi aplicada a Escala Visual Analógica (EAV), para avaliação da sensibilidade dolorosa à injeção. Resultado A comparação entre os métodos revelou que o convencional mostrou induzir maiores valores na EAV do que o Morpheus. O teste do Qui-Quadrado, para proporções esperadas iguais, mostrou que a técnica com Morpheus obteve maior (p=0,0062) preferência do que a convencional. Conclusão No conjunto, os dados revelam que a técnica empregando o Morpheus foi superior à convencional nos três momentos. A execução da anestesia realizada com Morpheus mostrou ser mais confortável e ter aceitação e maior preferência dos voluntários.
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Visconti RP, Tortamano IP, Buscariolo IA. Comparison of the Anesthetic Efficacy of Mepivacaine and Lidocaine in Patients with Irreversible Pulpitis: A Double-blind Randomized Clinical Trial. J Endod 2016; 42:1314-9. [PMID: 27475099 DOI: 10.1016/j.joen.2016.06.015] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2016] [Revised: 05/26/2016] [Accepted: 06/16/2016] [Indexed: 10/21/2022]
Abstract
INTRODUCTION The objective of this study was to compare the anesthetic efficacy of 2% mepivacaine combined with 1:100,000 epinephrine with 2% lidocaine combined with 1:100,000 epinephrine during pulpectomy of mandibular posterior teeth in patients with irreversible pulpitis. METHODS Forty-two patients with irreversible pulpitis who were admitted to the Emergency Center at the University of São Paulo School of Dentistry volunteered to take part in the study and were randomized to receive conventional inferior alveolar nerve block containing 1.8 or 3.6 mL of either 2% mepivacaine with 1:100,000 epinephrine or 2% lidocaine with 1:100,000 epinephrine. We recorded patients' subjective assessments of lip anesthesia, absence/presence of pulpal anesthesia tested by using electric pulp stimulation, and absence/presence of pain during the subsequent pulpectomy by using a verbal analogue scale. RESULTS All patients tested reported lip anesthesia after application of either type of inferior alveolar nerve block. Pulpal anesthesia success rates measured by using the pulp tester were satisfactory for both solutions (86% for mepivacaine and 67% for lidocaine). Success rates according to patient report of no pain or mild pain during pulpectomy were higher for mepivacaine solution (55%) than for lidocaine solution (14%). The differences between mepivacaine and lidocaine were statistically significant. CONCLUSIONS Mepivacaine resulted in effective pain control during irreversible pulpitis treatments. The success rates with either solution were not high enough to ensure complete pulpal anesthesia.
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Affiliation(s)
- Renata Pieroni Visconti
- Department of Stomatology, Integrated Clinical Discipline, University of São Paulo School of Dentistry, São Paulo, Sao Paulo, Brazil.
| | - Isabel Peixoto Tortamano
- Department of Stomatology, Integrated Clinical Discipline, University of São Paulo School of Dentistry, São Paulo, Sao Paulo, Brazil
| | - Inês Aparecida Buscariolo
- Department of Stomatology, Integrated Clinical Discipline, University of São Paulo School of Dentistry, São Paulo, Sao Paulo, Brazil
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Shadmehr E, Aminozarbian MG, Akhavan A, Mahdavian P, Davoudi A. Anaesthetic efficacy of lidocaine/clonidine for inferior alveolar nerve block in patients with irreversible pulpitis. Int Endod J 2016; 50:531-539. [DOI: 10.1111/iej.12659] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2015] [Accepted: 05/11/2016] [Indexed: 11/29/2022]
Affiliation(s)
- E. Shadmehr
- Torabinejad Research Center; Departments of Endodontics; Isfahan University of Medical Sciences; Isfahan Iran
| | - M. G. Aminozarbian
- Torabinejad Research Center; Departments of Endodontics; Isfahan University of Medical Sciences; Isfahan Iran
| | - A. Akhavan
- Torabinejad Research Center; Departments of Endodontics; Isfahan University of Medical Sciences; Isfahan Iran
| | - P. Mahdavian
- Dental Students Research Center; School of Dentistry; Isfahan University of Medical Sciences; Isfahan Iran
| | - A. Davoudi
- Dental Students Research Center; School of Dentistry; Isfahan University of Medical Sciences; Isfahan Iran
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Aggarwal V, Singla M, Miglani S, Kohli S. Comparative Evaluation of Mental Incisal Nerve Block, Inferior Alveolar Nerve Block, and Their Combination on the Anesthetic Success Rate in Symptomatic Mandibular Premolars: A Randomized Double-blind Clinical Trial. J Endod 2016; 42:843-5. [DOI: 10.1016/j.joen.2016.02.015] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2015] [Revised: 02/12/2016] [Accepted: 02/26/2016] [Indexed: 11/24/2022]
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Aggarwal V, Singla M, Subbiya A, Vivekanandhan P, Sharma V, Sharma R, Prakash V, Geethapriya N. Effect of Preoperative Pain on Inferior Alveolar Nerve Block. Anesth Prog 2016; 62:135-9. [PMID: 26650491 DOI: 10.2344/15-00019.1] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
The present study tested the hypothesis that the amount and severity of preoperative pain will affect the anesthetic efficacy of inferior alveolar nerve block (IANB) in patients with symptomatic irreversible pulpitis. One-hundred seventy-seven adult volunteer subjects, actively experiencing pain in a mandibular molar, participated in this prospective double-blind study carried out at 2 different centers. The patients were classified into 3 groups on the basis of severity of preoperative pain: mild, 1-54 mm on the Heft-Parker visual analog scale (HP VAS); moderate, 55-114 mm; and severe, greater than 114 mm. After IANB with 1.8 mL of 2% lidocaine, endodontic access preparation was initiated. Pain during treatment was recorded using the HP VAS. The primary outcome measure was the ability to undertake pulp access and canal instrumentation with no or mild pain. The success rates were statistically analyzed by multiple logistic regression test. There was a significant difference between the mild and severe preoperative pain group (P = .03). There was a positive correlation between the values of preoperative and intraoperative pain (r = .2 and .4 at 2 centers). The amount of preoperative pain can affect the anesthetic success rates of IANB in patients with symptomatic irreversible pulpitis.
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Affiliation(s)
- Vivek Aggarwal
- Department of Conservative Dentistry & Endodontics, Faculty of Dentistry, Jamia Millia Islamia, New Delhi, India
| | - Mamta Singla
- Department of Conservative Dentistry & Endodontics, SGT Dental College, Gurgaon, India
| | - Arunajatesan Subbiya
- Department of Conservative Dentistry & Endodontics, Sree Balaji Dental College and Hospital, Chennai, India
| | - Paramasivam Vivekanandhan
- Department of Conservative Dentistry & Endodontics, Sree Balaji Dental College and Hospital, Chennai, India
| | - Vikram Sharma
- Department of Conservative Dentistry & Endodontics, SGT Dental College, Gurgaon, India
| | - Ritu Sharma
- Department of Conservative Dentistry & Endodontics, SGT Dental College, Gurgaon, India
| | - Venkatachalam Prakash
- Department of Conservative Dentistry & Endodontics, Sree Balaji Dental College and Hospital, Chennai, India
| | - Nagarajan Geethapriya
- Department of Conservative Dentistry & Endodontics, Sree Balaji Dental College and Hospital, Chennai, India
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de Souza Melo MR, Sabey MJS, Lima CJ, de Almeida Souza LM, Groppo FC. The Effect of 2 Injection Speeds on Local Anesthetic Discomfort During Inferior Alveolar Nerve Blocks. Anesth Prog 2016; 62:106-9. [PMID: 26398126 DOI: 10.2344/11-00037.1] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
This randomized double-blind crossover trial investigated the discomfort associated with 2 injection speeds, low (60 seconds) and slow (100 seconds), during inferior alveolar nerve block by using 1.8 mL of 2% lidocaine with 1 : 100,000 epinephrine. Three phases were considered: (a) mucosa perforation, (b) needle insertion, and (c) solution injection. Thirty-two healthy adult volunteers needing bilateral inferior alveolar nerve blocks at least 1 week apart were enrolled in the present study. The anesthetic procedure discomfort was recorded by volunteers on a 10-cm visual analog scale in each phase for both injection speeds. Comparison between the 2 anesthesia speeds in each phase was performed by paired t test. Results showed no statistically significant difference between injection speeds regarding perforation (P = .1016), needle placement (P = .0584), or speed injection (P = .1806). The discomfort in all phases was considered low. We concluded that the 2 injection speeds tested did not affect the volunteers' pain perception during inferior alveolar nerve blocks.
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Affiliation(s)
| | | | | | | | - Francisco Carlos Groppo
- Chairman Professor, Dentistry School of Piracicaba, University of Campinas, São Paulo, Brazil
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Schellenberg J, Drum M, Reader A, Nusstein J, Fowler S, Beck M. Effect of Buffered 4% Lidocaine on the Success of the Inferior Alveolar Nerve Block in Patients with Symptomatic Irreversible Pulpitis: A Prospective, Randomized, Double-blind Study. J Endod 2015; 41:791-6. [DOI: 10.1016/j.joen.2015.02.022] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2014] [Revised: 02/13/2015] [Accepted: 02/15/2015] [Indexed: 12/01/2022]
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Click V, Drum M, Reader A, Nusstein J, Beck M. Evaluation of the Gow-Gates and Vazirani-Akinosi Techniques in Patients with Symptomatic Irreversible Pulpitis: A Prospective Randomized Study. J Endod 2015; 41:16-21. [DOI: 10.1016/j.joen.2014.09.010] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2014] [Accepted: 09/16/2014] [Indexed: 10/24/2022]
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Al-Delayme REM. A comparison of two anesthesia methods for the surgical removal of maxillary third molars: PSA nerve block technique vs. local infiltration technique. J Clin Exp Dent 2014; 6:e12-6. [PMID: 24596629 PMCID: PMC3935899 DOI: 10.4317/jced.51199] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2013] [Accepted: 11/21/2013] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVES The purpose of this study was to compare the effect of PSA block injection with infiltration technique regarding local anesthesia for surgical extraction of upper third molar. MATERIAL AND METHODS A prospective, intra individual, single-blind randomized controlled trial was designed to study the severity of pain during injection and after surgical extraction of the bilaterally and symmetrically similar upper third molar in a total of 53 patients, in addition to evaluating the need to repeat the injection and requirement of post operative anti-inflammatory tablets. RESULT Although the average pain score for all studied times in PSA side was lower than the average pain score in infiltration technique, repeated statistical measures demonstrated that no significant pain reduction occurred in the two techniques. CONCLUSION The both tested methods have the same statistic equivalence for the surgical extraction of maxillary third molars. Key words:Surgical extraction, maxillary third molars, PSA block, infiltration.
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Affiliation(s)
- Ra Ed Ma Al-Delayme
- B.D.S, S.OMFS.S, C.A.B.OMFS, M.F.D. R.C.S. I., M.O.M.S. R.C.P.S .G, F.F.D (OSOM) R.C.S.I. Dean of The Faculty of Dentistry, Dijla University College, Baghdad, Iraq ; B.D.S, S.OMFS.S, C.A.B.OMFS, M.F.D. R.C.S. I., M.O.M.S. R.C.P.S .G, F.F.D (OSOM) R.C.S. I. Senior Specialist at Oral and Maxillofacial Surgery Dept., AL-Yarmuk Teaching Hospital, Baghdad, Iraq
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Fullmer S, Drum M, Reader A, Nusstein J, Beck M. Effect of Preoperative Acetaminophen/Hydrocodone on the Efficacy of the Inferior Alveolar Nerve Block in Patients with Symptomatic Irreversible Pulpitis: A Prospective, Randomized, Double-blind, Placebo-controlled Study. J Endod 2014; 40:1-5. [DOI: 10.1016/j.joen.2013.09.009] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2013] [Revised: 08/27/2013] [Accepted: 09/06/2013] [Indexed: 11/26/2022]
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Aggarwal V, Singla M, Miglani S, Kohli S, Irfan M. A prospective, randomized single-blind evaluation of effect of injection speed on anesthetic efficacy of inferior alveolar nerve block in patients with symptomatic irreversible pulpitis. J Endod 2012; 38:1578-80. [PMID: 23146640 DOI: 10.1016/j.joen.2012.08.006] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2012] [Revised: 08/21/2012] [Accepted: 08/21/2012] [Indexed: 11/25/2022]
Abstract
INTRODUCTION Speed of injection may affect the solution spread in the pterygomandibular space. It was hypothesized that speed of injection will affect the anesthetic efficacy of inferior alveolar nerve block (IANB) in patients with symptomatic irreversible pulpitis. METHODS Fifty-nine adult volunteers who were actively experiencing pain participated in this prospective, randomized, single-blind study. The patients were divided into 2 groups on a random basis and received either slow or rapid IANB with 3.6 mL of 2% lidocaine with 1:200,000 epinephrine. Endodontic access preparation was initiated after 15 minutes of the initial IANB. Pain during treatment was recorded by using the Heft-Parker visual analogue scale. The primary outcome measure, and the definition of success, was the ability to undertake pulp access and canal instrumentation with no or mild pain (Heft-Parker visual analog scale score < 55 mm). Secondary outcome measure was the solution deposition pain. Statistical analysis was performed by using Mann-Whitney U test and χ(2) test. RESULTS Slow and rapid injections gave 43% and 51% success rates, respectively. The difference was statistically insignificant. Slow injections produced less solution deposition pain than rapid injections. CONCLUSIONS Rate of injection has no effect on anesthetic success of IANB, but slow injections were more comfortable than rapid injections.
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Affiliation(s)
- Vivek Aggarwal
- Department of Conservative Dentistry and Endodontics, Faculty of Dentistry, Jamia Millia Islamia, New Delhi, India.
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Anesthetic efficacy of combinations of 0.5 mol/L mannitol and lidocaine with epinephrine for inferior alveolar nerve blocks in patients with symptomatic irreversible pulpitis. J Endod 2012; 38:598-603. [PMID: 22515886 DOI: 10.1016/j.joen.2012.02.016] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2011] [Revised: 02/08/2012] [Accepted: 02/09/2012] [Indexed: 10/28/2022]
Abstract
INTRODUCTION The purpose of these 2 prospective, randomized, single-blind studies was to determine the anesthetic efficacy of lidocaine with epinephrine compared with a combination lidocaine with epinephrine plus 0.5 mol/L mannitol for inferior alveolar nerve (IAN) blocks in patients experiencing symptomatic irreversible pulpitis. METHODS In study one, 55 emergency patients randomly received IAN blocks by using a 3.18-mL formulation containing 63.6 mg of lidocaine with 31.8 μg epinephrine or a 5-mL formulation containing 63.6 mg of lidocaine with 31.8 μg epinephrine (3.18 mL) plus 1.82 mL of 0.5 mol/L mannitol. In study two, 51 emergency patients randomly received IAN blocks by using a 1.9-mL formulation containing 76.4 mg of lidocaine with 36 μg epinephrine or a 3-mL formulation containing 76.4 mg of lidocaine with 36 μg epinephrine (1.9 mL) plus 1.1 mL of 0.5 mol/L mannitol. Endodontic access was begun 15 minutes after the IAN block, and all patients had profound lip numbness. Success was defined as no or mild pain (visual analogue scale recordings) on endodontic access or instrumentation. RESULTS The 1.9 mL of lidocaine (76.4 mg) with epinephrine plus 0.5 mol/L mannitol had a significantly (P = .04) better success rate of 39% when compared with the lidocaine formulation without mannitol (13% success rate). CONCLUSIONS For mandibular posterior teeth in patients with symptomatic irreversible pulpitis, the addition of 0.5 mol/L mannitol to 1.9 mL of lidocaine (76.4 mg) with epinephrine resulted in a statistically higher success rate. However, the combination lidocaine/mannitol formulation would not result in predictable pulpal anesthesia.
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Drum M, Reader A, Beck M. Long buccal nerve block injection pain in patients with irreversible pulpitis. ACTA ACUST UNITED AC 2011; 112:e51-4. [DOI: 10.1016/j.tripleo.2011.01.028] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2010] [Revised: 01/21/2011] [Accepted: 01/22/2011] [Indexed: 11/27/2022]
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Pain Prevalence and Severity before, during, and after Root Canal Treatment: A Systematic Review. J Endod 2011; 37:429-38. [DOI: 10.1016/j.joen.2010.12.016] [Citation(s) in RCA: 199] [Impact Index Per Article: 15.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2010] [Revised: 12/10/2010] [Accepted: 12/20/2010] [Indexed: 11/18/2022]
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Parirokh M, Ashouri R, Rekabi AR, Nakhaee N, Pardakhti A, Askarifard S, Abbott PV. The Effect of Premedication with Ibuprofen and Indomethacin on the Success of Inferior Alveolar Nerve Block for Teeth with Irreversible Pulpitis. J Endod 2010; 36:1450-4. [DOI: 10.1016/j.joen.2010.05.007] [Citation(s) in RCA: 63] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2010] [Revised: 05/01/2010] [Accepted: 05/19/2010] [Indexed: 11/26/2022]
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Efficacy of combining a buccal infiltration with an inferior alveolar nerve block for mandibular molars with irreversible pulpitis. ACTA ACUST UNITED AC 2010; 109:468-73. [DOI: 10.1016/j.tripleo.2009.11.016] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2009] [Revised: 11/09/2009] [Accepted: 11/11/2009] [Indexed: 11/20/2022]
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