scholarly journals Effect of laser assisted local anesthesia in single-visit root canal treatment for mandibular molar teeth with acute irreversible pulpitis

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.

2013 ◽  
Vol 5 (2) ◽  
pp. 21-25
Author(s):  
Manjunath. Shankariah ◽  
Malapati Sudhakar Rao ◽  
Kalappa T Muthanna

ABSTRACT Background The blood aspiration technique before the injection of local anesthetic solution is an essential procedure, because it prevents possible systemic’ complications. The purpose of this study is to evaluate the incidence of intravascular injection in different techniques of inferior alveolar nerve block and to know the technique which has very low incidence of vascular penetration. Methods Fifty patients in the ages of 17-70 years irrespective of sex, who were indicated for bilateral extractions of mandibular teeth were selected for this study. Patients were randomly divided into two divisions consisting of 25 patients requiring bilateral extraction procedures. In first division classical technique of inferior alveolar nerve block was administered on one side and on 2nd appointment Angelo Sargenti technique was administered on the other side. In the second division of 25 patients, indirect technique was administered on one side in 1st appointment and Clark and Holmes technique was administered on the other side in next appointment. Incidence of positive aspiration due to inadvertent penetration of inferior alveolar vessels was recorded. Results In group I positive aspiration rate was 8%, group II it was 4%, group III it was 4% and group IV it was 8%. Chi-square and fisher exact test was used and statistically there was no significant difference in the incidence of positive aspiration in all four groups. We found an overall aspiration rate of 6% in all four groups. Conclusion The incidence of positive aspiration was evaluated in all the 4 groups. There was no statistical significance in the rate of positive aspiration in all the groups included in our study.


2016 ◽  
Vol 40 (4) ◽  
pp. 301-305 ◽  
Author(s):  
Radhika Chopra ◽  
Mohita Marwaha ◽  
Kalpana Bansal ◽  
Meenu Mittal

Objective: Failure of inferior alveolar nerve block in achieving profound anesthesia of the pulp due to various reasons has led to the introduction of more potent local anesthetic agents like articaine. This study was conducted to compare the efficacy of buccal infiltration with articaine in achieving pulpal anesthesia of primary molars as compared to inferior alveolar nerve block with lignocaine. Study design: 30 patients (4–8 years) with indication of pulp therapy in at least two mandibular primary molars were selected. Patients were randomly assigned to receive nerve block with lignocaine or infiltration with articaine on first appointment and the other solution on second appointment. All the pulpotomies and pulpectomies were performed by a pediatric dentist. Two researchers standing at a distance of 1.5 m recorded the Pain Scores and Sound, Eye, Motor (SEM) scores. After the completion of procedure, the patient was asked to record the Facial Image score and Heft-Parker Visual Analogue Score (HP-VAS). Results: Pain Score recorded at the time of injection showed significantly more movements with block as compared to infiltration (p<0.001). SEM scores at time of pulp extirpation were also higher for block than infiltration (p<0.001). Conclusion: Articaine infiltration has the potential to replace inferior alveolar nerve block for primary mandibular molars.


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.


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.


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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