Programmed-release intraosseus anesthesia as an alternative to lower alveolar nerve block in lower third molar extraction: a randomized clinical trial.

Anesthesia Inferior Alveolar Nerve Intraosseous Nerve Block Tooth Extraction

Journal

Journal of dental anesthesia and pain medicine
ISSN: 2383-9309
Titre abrégé: J Dent Anesth Pain Med
Pays: Korea (South)
ID NLM: 101690691

Informations de publication

Date de publication:
Jun 2022
Historique:
received: 12 09 2021
revised: 09 05 2022
accepted: 23 05 2022
entrez: 13 6 2022
pubmed: 14 6 2022
medline: 14 6 2022
Statut: ppublish

Résumé

Intraosseous anesthesia is the process by which an anesthetic solution, after penetration of the cortical bone, is directly injected into the spongiosa of the alveolar bone supporting the tooth. This study aimed to compare the effectiveness of the traditional inferior alveolar nerve block (IANB) and computerized intraosseous anesthesia in the surgical extraction of impacted lower third molars, compare their side effects systemically by monitoring heart rate, and assess patients' a posteriori preference of one technique over the other. Thirty-nine patients with bilaterally impacted third molars participated in this study. Each patient in the sample was both a case and control, where the conventional technique was randomly assigned to one side (group 1) and the alternative method to the contralateral side (group 2). The traditional technique was faster in execution than anesthesia delivered via electronic syringe, which took 3 min to be administered. However, it was necessary to wait for an average of 6 ± 4 min from the execution to achieve the onset of IANB, while the latency of intraosseous anesthesia was zero. Vincent's sign and lingual nerve anesthesia occurred in 100% of cases in group 1. In group 2, Vincent's sign was recorded in 13% of cases and lingual anesthesia in four cases. The average duration of the perceived anesthetic effect was 192 ± 68 min in group 1 and 127 ± 75 min in group 2 (P < 0.001). The difference between the heart rate of group 1 and group 2 was statistically significant. During infiltration in group 1, heartbeat frequency increased by 5 ± 13 beats per minute, while in group 2, it increased by 22 ± 10 beats per minute (P < 0.001). No postoperative complications were reported for either technique. Patients showed a preference of 67% for the alternative technique and 20% for the traditional, and 13% of patients were indifferent. The results identified intraosseous anesthesia as a valid alternative to conventional anesthesia in impacted lower third molar extraction.

Sections du résumé

Background UNASSIGNED
Intraosseous anesthesia is the process by which an anesthetic solution, after penetration of the cortical bone, is directly injected into the spongiosa of the alveolar bone supporting the tooth. This study aimed to compare the effectiveness of the traditional inferior alveolar nerve block (IANB) and computerized intraosseous anesthesia in the surgical extraction of impacted lower third molars, compare their side effects systemically by monitoring heart rate, and assess patients' a posteriori preference of one technique over the other.
Methods UNASSIGNED
Thirty-nine patients with bilaterally impacted third molars participated in this study. Each patient in the sample was both a case and control, where the conventional technique was randomly assigned to one side (group 1) and the alternative method to the contralateral side (group 2).
Results UNASSIGNED
The traditional technique was faster in execution than anesthesia delivered via electronic syringe, which took 3 min to be administered. However, it was necessary to wait for an average of 6 ± 4 min from the execution to achieve the onset of IANB, while the latency of intraosseous anesthesia was zero. Vincent's sign and lingual nerve anesthesia occurred in 100% of cases in group 1. In group 2, Vincent's sign was recorded in 13% of cases and lingual anesthesia in four cases. The average duration of the perceived anesthetic effect was 192 ± 68 min in group 1 and 127 ± 75 min in group 2 (P < 0.001). The difference between the heart rate of group 1 and group 2 was statistically significant. During infiltration in group 1, heartbeat frequency increased by 5 ± 13 beats per minute, while in group 2, it increased by 22 ± 10 beats per minute (P < 0.001). No postoperative complications were reported for either technique. Patients showed a preference of 67% for the alternative technique and 20% for the traditional, and 13% of patients were indifferent.
Conclusion UNASSIGNED
The results identified intraosseous anesthesia as a valid alternative to conventional anesthesia in impacted lower third molar extraction.

Identifiants

pubmed: 35693356
doi: 10.17245/jdapm.2022.22.3.217
pmc: PMC9171337
doi:

Types de publication

Journal Article

Langues

eng

Pagination

217-226

Informations de copyright

Copyright © 2022 Journal of Dental Anesthesia and Pain Medicine.

Déclaration de conflit d'intérêts

DECLARATION OF INTERESTS: The authors have no conflicts of interest to declare.

Références

Anesth Essays Res. 2014 Jan-Apr;8(1):3-8
pubmed: 25886095
J Dent (Shiraz). 2018 Mar;19(1):57-62
pubmed: 29492417
Hua Xi Kou Qiang Yi Xue Za Zhi. 2011 Aug;29(4):389-92
pubmed: 21932660
Anesth Essays Res. 2017 Apr-Jun;11(2):431-438
pubmed: 28663636
Oral Surg Oral Med Oral Pathol Oral Radiol. 2012 Nov;114(5 Suppl):S132-9
pubmed: 23063389
J Prosthet Dent. 2017 May;117(5S):e1-e105
pubmed: 28418832
Med Oral Patol Oral Cir Bucal. 2012 May 01;17(3):e426-9
pubmed: 22143722
Int J Paediatr Dent. 2009 Sep;19(5):360-6
pubmed: 19486372
Eur J Paediatr Dent. 2017 Sep;18(3):221-225
pubmed: 29254346
J Nat Sci Biol Med. 2012 Jul;3(2):156-60
pubmed: 23225978
Anesth Prog. 1989 Jul-Oct;36(4-5):198-200
pubmed: 2490032
J Am Dent Assoc. 1982 Jan;104(1):41-3
pubmed: 6948029

Auteurs

Renato Pol (R)

Oral Surgery Unit, Dentistry Section, Department of Surgical Sciences, University of Turin, Dental School, Turin, Italy.

Tiziana Ruggiero (T)

Oral Surgery Unit, Dentistry Section, Department of Surgical Sciences, University of Turin, Dental School, Turin, Italy.

Marta Bezzi (M)

Oral Surgery Unit, Dentistry Section, Department of Surgical Sciences, University of Turin, Dental School, Turin, Italy.

Davide Camisassa (D)

Oral Surgery Unit, Dentistry Section, Department of Surgical Sciences, University of Turin, Dental School, Turin, Italy.

Stefano Carossa (S)

Oral Surgery Unit, Dentistry Section, Department of Surgical Sciences, University of Turin, Dental School, Turin, Italy.

Classifications MeSH