Patient’s pain perception during mandibular molar extraction with articaine: a comparison study between infiltration and inferior alveolar nerve block

2016 ◽  
Vol 20 (8) ◽  
pp. 2241-2250 ◽  
Author(s):  
Anwar B. Bataineh ◽  
Majid A. Alwarafi
2016 ◽  
Vol 6 (3) ◽  
Author(s):  
Ibrahim Nasseh ◽  
Georges Aoun

One of the rare anatomical variations that can be of significant importance for the dentist is the bifid mandibular canal. Many complications can occur from this condition such as failure of anesthesia when performing inferior alveolar nerve block, difficulties during the surgical extraction of the third mandibular molar, and during implants placement. Therefore, good knowledge of this condition is essential. In this report, we describe the radiographic finding of a unilateral bifid mandibular canal.


2021 ◽  
Vol 12 (46) ◽  
pp. 76-80
Author(s):  
Adel Martínez-Martínez ◽  
Samuel Urbano del Valle ◽  
Johnatan Zambrano Trespalacios

Inferior alveolar nerve block in the mandibular technique is the blockade that presents most failures in the dental practice, so this technique is considered the less effective of those used in Dentistry and the most frustrating to the dentist. This study aimed to determine pain intensity during dental procedures after using 4% articaine with epinephrine 1:100000 in the inferior alveolar nerve block with buccal infiltration in patients who were attended in the dental clinic of the University of Cartagena, Colombia. A clinical randomized trial was performed. The sample was of patients who required dental procedures in the jaw with local anesthesia. After standardization of the anesthetic technique, and use of 4% articaine with epinephrine 1:100000, the inferior alveolar nerve was blocked with 0.9 mL (half cartridge) followed by buccal infiltration with 0.9 mL in the first mandibular molar. Fifty patients (30 men - 60% and 20 women - 40%), with an average age of 25.3 years old (mean ± standard deviation [SD]: 25.3 ± 6.6) were included in the study. When assessing the pain puncture and during the injection, 92% of patients classified it as mild pain according to VAS. When evaluating the latency period, the average time was less than two minutes and the perioral soft tissue anesthesia was 97%. Only a small percentage of patients required complementary anesthesia. The authors recommend the use of 4% of articaine with epinephrine in mandibular procedures that require deep pulp anesthesia, using this with a buccal infiltration.


2021 ◽  
pp. 36-38
Author(s):  
Khushal Desai ◽  
Manasi Bavaskar

BACKGROUND: Profound pulpal anaesthesia using the inferior alveolar nerve block (IANB) technique for extraction of mandibular posterior teeth is difcult to achieve. Several authors emphasised the effects of intraligamentary injection anaesthesia (ILA), also known as periodontal injection; as a primary or supplementary technique. The aim of this study was to compare the efcacy of ILA over IANB technique in providing adequate and superior anaesthesia for extraction of mandibular premolars and molars. MATERIALS AND METHODS: 30 patients requiring bilateral extractions of mandibular posterior teeth were selected. The parameters evaluated were subjective (numbness) and objective (pain on gingival probing) signs of anaesthesia, difference in pain perception during the procedure; and duration of anaesthesia for ILA (Group A) and IANB technique (Group B). RESULTS: The results showed that no difference was found in terms of subjective and objective evaluation of anaesthesia between the groups. A statistically signicant difference was seen in Group A, where intraligamentary injection anaesthesia showed less pain perception than the IANB technique. However, longer duration of anaesthesia was noted in Group B. CONCLUSION: With fewer failures and complications, the intraligamentary injection can be effectively used as a primary technique to alleviate pain and profoundly anaesthetize the mandibular posterior teeth during dento-alveolar extraction procedure.


2021 ◽  
Author(s):  
Subashri V ◽  
Nivedha V ◽  
Anand Sherwood ◽  
Paul Abbott ◽  
James L Gutmann ◽  
...  

Present study evaluated the efficacy of laser activation to control intra- and post-operative pain in single-visit root treatment for mandibular molar teeth with acute irreversible pulpitis following 2% lignocaine inferior alveolar nerve block. Ninety-eight patients presenting with pain were randomly divided into two anesthetic groups. Group-I inferior alveolar nerve block plus buccal infiltration and intra-ligamentary injections, Group-II inferior alveolar nerve block followed by laser irradiation focused directly on the pulp tissue. Intra- and post-operative pain intensities were assessed on a 10-point scale. The mean intra-operative pain scores in group-I was 6.62 and in group-II before and after laser irradiation pain scores was 6.94 and 1.3, respectively. Post-operative pain scores at 24-hrs in the laser group were significantly higher. Laser irradiation applied directly on pulp tissue for control of intra-operative pain was effective, thereby negating the need for additional local anesthesia.


2018 ◽  
Vol 7 (9) ◽  
Author(s):  
María del Pilar Rodríguez Sánchez ◽  
Jadison Junio Conforte ◽  
João Paulo Bonardi ◽  
Débora Bressan Galafassi ◽  
Daniela Ponzoni

The aim of this study was to evaluate the anaesthetic failure rate of the pterygomandibular technique with an inferior alveolar nerve block in lower third molar extraction procedures.  Materials and Methods: A total of 67 healthy patients (men and women, aged between 18–35 years) requiring third molar extractions were selected from the Discipline of Surgery, of the Araçatuba Dental School. The anaesthetic technique utilised was a pterygomandibular block using 2% mepivacaine hydrochloride with epinephrine 1:100,000 (Mepivalem®) in a maximum standardised amount of three tubes (5.4 ml) per procedure (performed by the same operator). Surgical procedures were initiated after confirming the sensation of anaesthesia in the area anesthetised at the inferior alveolar nerve. Painful symptoms were recorded during surgery. Results: In total, 117 surgical procedures, i.e., 114 exodontias and three coronectomies, were performed. During surgical procedures, four patients reported pain during manoeuvres of odontosection, representing an anaesthetic failure rate of 3.41%. Alternative techniques utilised in these four patients involved milohioideo nerve, intraligamentaria, and intrapulpal anaesthesia. Conclusion: The success of inferior alveolar nerve block anaesthesia is difficult to predict due to large anatomical variations, and it is difficult to observe via diagnostic means. The relatively low percentage of anaesthetic failure reported in this study may be related to the number of procedures performed.Descriptors: Anesthesia, Dental; Anesthesia, Local; Molar, Third.


2015 ◽  
Vol 62 (4) ◽  
pp. 135-139 ◽  
Author(s):  
Vivek Aggarwal ◽  
Mamta Singla ◽  
Arunajatesan Subbiya ◽  
Paramasivam Vivekanandhan ◽  
Vikram Sharma ◽  
...  

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.


2021 ◽  
Vol 15 (7) ◽  
pp. 1626-1628
Author(s):  
Shakeel Ahmad ◽  
Usman Sana ◽  
Muhammad Haseeb ◽  
Iffat Umair Niazi ◽  
Zubair Ahmed Khan ◽  
...  

Aim: To understand impact of pre-operative anxiety during inferior alveolar nerve block based on pain perception. Methods: Data of 299 dental patients who collected. These patient were treated for restorative need in the Dental Section of Islam Dental College, Sialkot. Modified. Dental. Anxiety. Scale. (MDAS) was used to assess the patient’s anxiety levels.. Visual. analog. scale. was used to document the pain perceived of inferior alveolar nerve block. Results.: Anxiety and pain showed a statistically significant correlation-ship. Our findings were suggestive of increased pain associated with anxiety. Conclusion.: Assessment of anxiety levels prior to performing painful procedures can pro-actively benefit the patient and the operator. Yes, advanced methods of pain control are available but they need to be implicated judiciously. Assessing patient’s anxiety and then providing dental care will help improve dental care. Keywords.: Local anaesthesia (LA), Inferior alveolar nerve block IANB, dental anxiety


2017 ◽  
Vol 16 (3) ◽  
pp. 370-374 ◽  
Author(s):  
Pardeep Mahajan ◽  
Gurbant Singh ◽  
Roopinder Kaur ◽  
Prashant Monga ◽  
Vanita ◽  
...  

Introduction: Aim of this study was to evaluate the effective of premedication and to determine the difference between non steroidal anti- inflammatory drugs and centrally acting opioids like tramadol on success rate of inferior alveolar nerve block in patients with asymptomatic irreversible pulpitis.Methods: This double blind clinical study was conducted on 60 patients with asymptomatic irreversible pulpitis in first or second mandibular molar with normal periapical radiographic findings. Three medications i.e., ibuprofen (600mg), tramadol (50 mg) and combination of ibuprofen (400 mg) + acetaminophen (325) were compared and lactose powder capsules were taken as placebo. All patients received IANB and teeth were examined with a cold pulp test using endofrost. Then, endodontic access cavity preparation was initiated. In case of pain during treatment, patients were asked to rate their pain on the visual analog scale.Results: The tramadol group showed significantly higher success rates but ibuprofen and combination of ibuprofen and acetaminophen groups were not significant with placebo (p>05). No Significant differences were there regarding sex of the patients.Conclusion: Premedication with tramadol increased the success rate of IANB.Bangladesh Journal of Medical Science Vol.16(3) 2017 p.370-374


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