Pulpal anesthesia in pediatric patients following supplemental mandibular buccal infiltration in vital permanent mandibular molars with deep caries

Background: Local anesthetic injection is one of the most anxiety- provoking procedure for both children and adult patients in dentistry. A computerized system for slow delivery of local anesthetic has been developed as a possible solution to reduce the pain related to the local anesthetic injection. Study design: The present study was conducted to evaluate and compare pain perception rates in pediatric patients with computerized system and traditional methods, both objectively and subjectively. Study design: It was a randomized controlled study in one hundred children aged 8-12 years in healthy physical and mental state, assessed as being cooperative, requiring extraction of maxillary primary molars. Children were divided into two groups by random sampling - Group A received buccal and palatal infiltration injection using Wand, while Group B received buccal and palatal infiltration using traditional syringe. Visual Analog scale (VAS) was used for subjective evaluation of pain perception by patient. Sound, Eye, Motor (SEM) scale was used as an objective method where sound, eye and motor reactions of patient were observed and heart rate measurement using pulse oximeter was used as the physiological parameter for objective evaluation. Results: Patients experienced significantly less pain of injection with the computerized method during palatal infiltration, while less pain was not statistically significant during buccal infiltration. Heart rate increased during both buccal and palatal infiltration in traditional and computerized local anesthesia, but difference between traditional and computerized method was not statistically significant. Conclusion: It was concluded that pain perception was significantly more during traditional palatal infiltration injection as compared to computerized palatal infiltration, while there was no difference in pain perception during buccal infiltration in both the groups

Download Full-text

Efficacy of Articaine versus Lidocaine as a Supplemental Buccal Infiltration in Mandibular Molars with Irreversible Pulpitis: A Prospective, Randomized, Double-blind Study

Journal of Endodontics ◽

10.1016/j.joen.2013.12.022 ◽

2014 ◽

Vol 40 (6) ◽

pp. 753-758 ◽

Cited By ~ 30

Author(s):

Brandon S. Rogers ◽

Tatiana M. Botero ◽

Neville J. McDonald ◽

Richard J. Gardner ◽

Mathilde C. Peters

Keyword(s):

Blind Study ◽

Double Blind Study ◽

Double Blind ◽

Mandibular Molars ◽

Buccal Infiltration ◽

Irreversible Pulpitis

Download Full-text

Anesthetic Efficacy in Irreversible Pulpitis: A Randomized Clinical Trial

Brazilian Dental Journal ◽

10.1590/0103-6440201600663 ◽

2016 ◽

Vol 27 (4) ◽

pp. 381-386 ◽

Cited By ~ 16

Author(s):

Carlos E. Allegretti ◽

Roberta M. Sampaio ◽

Anna C. R. T. Horliana ◽

Paschoal L. Armonia ◽

Rodney G. Rocha ◽

...

Keyword(s):

Success Rate ◽

Nerve Block ◽

Inferior Alveolar Nerve ◽

Inferior Alveolar Nerve Block ◽

Posterior Teeth ◽

Mandibular Molars ◽

School Of Dentistry ◽

Mandibular Posterior Teeth ◽

Pulpal Anesthesia ◽

Irreversible Pulpitis

Abstract Inferior alveolar nerve block has a high failure rate in the treatment of mandibular posterior teeth with irreversible pulpitis. The aim of this study was to compare the anesthetic efficacy of 4% articaine, 2% lidocaine and 2% mepivacaine, all in combination with 1:100,000 epinephrine, in patients with irreversible pulpitis of permanent mandibular molars during a pulpectomy procedure. Sixty-six volunteers from the Emergency Center of the School of Dentistry, University of São Paulo, randomly received 3.6 mL of local anesthetic as a conventional inferior alveolar nerve block (IANB). The subjective signal of lip numbness, pulpal anesthesia and absence of pain during the pulpectomy procedure were evaluated respectively, by questioning the patient, stimulation using an electric pulp tester and a verbal analogue scale. All patients reported the subjective signal of lip numbness. Regarding pulpal anesthesia success as measured with the pulp tester, the success rate was respectively 68.2% for mepivacaine, 63.6% for articaine and 63.6% for lidocaine. Regarding patients who reported no pain or mild pain during the pulpectomy, the success rate was, respectively 72.7% for mepivacaine, 63.6% for articaine and 54.5% for lidocaine. These differences were not statistically significant. Neither of the solutions resulted in 100% anesthetic success in patients with irreversible pulpitis of mandibular molars.

Download Full-text