Programmed-release intraosseus anesthesia as an alternative to lower alveolar nerve block in lower third molar extraction: a randomized clinical trial (original) (raw)
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Avicenna Journal of Dental Research, 2013
Background: In spite of common usage of the inferior alveolar nerve block (IANB), this method has some well-defined restrictions. Objectives: The purpose of the present study was to compare these two techniques for the surgical removal of impacted lower third molars. Patients and Methods: A total of 44 similarly impacted lower third molars (22 patients with two similar teeth) were selected. In each patient, one side was anesthetized with the Gow-Gates technique and another side with the IANB, randomly. The number of injections for achieving anesthesia, incidence of pain during injections, and the supplementary injections during surgery were recorded for each side Results: In Gow-Gates technique, less repetition of injection was required to achieve anesthesia as well as less supplementary injections during surgery; however, these differences were not significant statistically (P = 0.39, P = 0.11). The pain during Gow-Gates injections was significantly shorter than that of the IANB (P = 0.007). Conclusions: Even though the patients felt less pain during the Gow-Gates injection, this technique has no advantage over the IANB during surgical removal of impacted lower third molar.
Journal of the Korean Association of Oral and Maxillofacial Surgeons
Objectives: Appropriate and accurate local anesthetic (LA) techniques are indispensable in the field of oral and maxillofacial surgery to obtain a satisfactory outcome for both the operating surgeon and the patient. When used alone, the inferior alveolar nerve block (IANB) technique requires supplemental injections like long buccal nerve block for extraction of mandibular molars leading to multiple traumatic experiences for the patient. The aim of this study was to anesthetize the inferior alveolar, lingual, and long buccal nerves with single-needle penetration requiring a minimal skillset such as administering a conventional IANB through introduction of the Benny Joseph technique for extraction of mandibular molars. Materials and Methods: This was a prospective study conducted in the Department of Oral and Maxillofacial Surgery, Kunhitharuvai Memorial Charitable Trust (KMCT) Dental College, Calicut, India. The duration of the study was 6 months, from June to November 2017, with a maximum sample size of 616 cases. The LA solution was 2% lignocaine with 1:100,000 adrenaline. The patients were selected from a population in the range of 20 to 40 years of age who reported to the outpatient department for routine dental extraction of normally positioned mandibular right or left first or second molars. Results: Of the 616 patients, 42 patients (6.8%) required re-anesthetization, a success rate of 93.2%. There were no complications such as hematoma formation, trismus, positive aspiration, and nerve injuries. None of the cases required re-anesthetization in the perioperative period. Conclusion: The Benny Joseph technique can be employed and is effective compared with conventional IANB techniques by reducing trauma to the patient and also requires less technique sensitivity.
Journal of Maxillofacial and Oral Surgery, 2013
Introduction Ropivacaine belongs to pipecoloxylidide group of local anesthetics. There are reports supporting the use of ropivacaine as a long acting local anesthetic in oral and maxillofacial surgical procedures, with variable data on the concentration that is clinically suitable. Materials and Methods A prospective randomized double-blind study protocol was undertaken to assess the efficacy of 0.5 and 0.75 % ropivacaine for inferior alveolar nerve block in surgical extraction of impacted mandibular third molars. A total of 60 procedures were performed, of which thirty patients received 0.5 % and thirty received 0.75 % concentration of the study drug. Results All the patients in both the study groups reported subjective numbness of lip and tongue. The time of onset was longer for 0.5 % ropivacaine when compared to 0.75 % solution. 90 % of the study patients in 0.5 % ropivacaine group reported pain corresponding to VAS C3 during bone guttering and 93.3 % patients reported pain corresponding to VAS [4 during tooth elevation. None of the patients in 0.75 % ropivacaine group reported VAS [3 at any stage of the surgical procedure. The duration of soft tissue anesthesia recorded with 0.75 % ropivacaine was average 287.57 ± 42.0 min. Conclusion 0.75 % ropivacaine was found suitable for inferior alveolar nerve blocks in surgical extraction of impacted mandibular third molars.
Journal of Maxillofacial and Oral Surgery, 2020
To compare the onset, duration and depth of anesthesia, postoperative pain, duration of analgesia and adverse reaction between 0.5% ropivacaine and 2% Lignocaine hydrochloride with adrenaline (1:80,000) in 40 patients having bilaterally impacted mandibular third molars. A prospective, randomized, single blind study was carried out among 40 patients requiring surgical removal of bilaterally impacted mandibular third molars having similar “difficulty index.” The onset of action, duration and depth of anesthesia, duration of analgesia, postoperative pain and adverse reactions of 0.5% ropivacaine and 2% lignocaine hydrochloride with 1:80,000 adrenaline were evaluated. All patients were infiltrated intradermally with 0.5 ml of 0.5% ropivacaine as test dose to rule out any allergic reaction. The surgical extractions of the impacted third molars were done using the standard surgical procedure. 0.5% Ropivacaine had higher depth of anesthesia, longer duration of action and postoperative anal...
Journal of Dental Anesthesia and Pain Medicine
Background: Mandibular third molar removal is the most common surgical procedure encountered in oral and maxillofacial clinics. It also presents the greatest challenges and controversies for surgeons when surgical removal is considered. Furthermore, diverse anesthesia results and success rates are achieved after using the same concentrations of different solutions or the same amounts of local anesthetics. The purpose of this study was to examine the efficiency of using double-cartridge (3.4 ml) 4% lidocaine (high concentration) and 4% articaine with a 1:100000 epinephrine infiltration in the retromolar region for impacted lower third molar surgery. Methods: This double-blind study included 30 patients with symmetrically impacted lower third molars. The patients were randomly selected to receive 4% articaine on one side and 4% lidocaine on the other, as a local anesthetic for third molar surgery. The onset, duration of soft-tissue numbness, pulpal sensitivity, amount of additional local anesthetic needed, pain score during the surgical procedure, and duration of the operation were recorded. Results: The results of this research indicate that 86.7% of the operations in the 4% articaine group and 83.3% of those in the 4% lidocaine group were successful. Furthermore, the outcomes in both groups were not statistically significant (P > 0.05). Numbness onset occurred faster in the articaine group than it did in the lidocaine group. However, the duration of soft-tissue anesthesia and pain scores recorded immediately postoperatively were similar. Conclusion: It is concluded that 4% lidocaine and 4% articaine had a similar infiltration efficacy in the retromolar region and both local anesthetics are adequate for impacted lower third molar surgery. There were no statistically significant differences between the two local anesthetics regarding pain control and the duration of soft-tissue numbness during the procedure.
2021
Local Anesthesia has the capability to block sensory stimuli.hypersensitivity is experienced during tooth preparation is referred to as Hyperesthesia and it can be managed by giving Infiltration or Nerve Block.A cross-sectional,descriptive study was conducted in a university, on randomly selected individuals.The study group consists of Adult patients who attended the outpatient Department of Prosthodontics from June 2019March 2020. 86,000 case sheets were reviewed and sampling was done using simple random sampling.A chi square test is done to evaluate the correlation between Sextant and Age with Type of Anesthesia given there is a correlation of Sextant and Anesthesia and there is no correlation of Age and Anesthesia.From the study we can say that most of the students preferred Infiltration Anesthesia over Nerve block Anesthesia during Tooth preparation so it is shown that Infiltration Anesthesia is chosen because it is easy and there is no any clinical complications
IP International Journal of Maxillofacial Imaging
Administration of local anesthetic drug that prevents pain during dental treatment is of absolute importance. Act of injecting local anesthetic should be nonpainful and atraumatic. The maxilla is very porous and highly vascular. Therefore, anesthesia of maxillary teeth can be accomplished more easily than with mandibular teeth. The aim of this study is to determine the anesthetic efficacy of the conventional technique of posterior superior alveolar (PSA) and greater palatine nerve(GP) block anesthesia as compared to the buccal and palatal technique in terms of pain during injection, after extraction, after 15mins of the procedure and quality of anesthesia during the extraction procedure. The study also intends to determine the incidence of positive aspiration in the infiltration technique. This randomized clinical study was carried out on 154 patients who reported to the Department of Oral and Maxillofacial Surgery, Sri Rajiv Gandhi College of Dental Sciences & Hospital Bangalore, r...
Palatal needle-free anesthesia for upper molars extraction. A randomized clinical trial
Journal of Cranio-Maxillofacial Surgery, 2020
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Links between anaesthetic modality and nerve damage during lower third molar surgery
British Dental Journal, 2002
Objective To investigate the relationships between eruption status, gender, social class, grade of operator, anaesthetic modality and nerve damage during third molar surgery. Design Two centre prospective longitudinal study. Setting The department of oral and maxillofacial surgery, University Hospital Birmingham NHS Trust and oral surgery outpatient clinics at Birmingham Dental Hospital. Subjects A total of 391 patients had surgical removal of lower third molars. Sensory disturbance was recorded at one week post operatively. Patients with altered sensation were followed up at one month, three months and six months following surgery. Results 614 lower third molars in 391 patients were removed. Fortysix procedures (7.5%) were associated with altered sensation at one week with three procedures (0.49%) showing persistent symptoms at six months. Of these 46 nerve injuries, 26 (4.23%) involved the lingual nerve and 20 (3.25%) the inferior dental nerve (IDN). All three persistent sensations were IDN related. A logistic regression model found that the use of a lingual retractor χ 2 =11.559, p=0.003 was more significant than eruption status χ 2 =12.935, p=0.007. There was no significant relationship between anaesthetic modality, age, social class, sex and seniority of operator. Conclusions There was no link between the choices of local or general anaesthesia and nerve damage during lower third molar removal when difficulty of surgery was taken into account.
World Journal of Dentistry, 2015
Introduction: Anterior middle superior alveolar (AMSA) block is a nerve block technique in conjunction with computer-controlled local anesthetic delivery (CCLAD) system. Anterior middle superior alveolar produces local anesthesia (LA) to the maxillary teeth from second premolar to the central incisor including the hard palate and corresponding soft-tissue of both buccal and palatal side, with single palatal injection. Aim: To evaluate efficacy of AMSA block for extraction of maxillary first premolar. Study design: In randomized single blind, split mouth clinical trial, the 14 patients received the conventional buccal-palatal (B-p) anesthesia on one side and CCLAD anesthesia AMSA for other side. the treatment consisted of bilateral extraction of maxillary first premolars for orthodontics. Pain perception ratings were obtained by using 10 point visual analog scale (VAS). Results: A total of 100% cases had painless injection with CCLAD, whereas 28.57% patients had painless injection experience with conventional LA. In all cases, there was no pain during extraction on both sides. With CCLAD, buccal retraction was painful in four cases whereas palatal retraction was painful in one case. Conclusion: Anterior middle superior alveolar block injected with CCLAD is better as LA technique for extraction of maxillary first premolar as compared to B-P approach.