scholarly journals Removal of a broken dental needle in the pterygomandibular space using an image intensifier: two case reports

2021 ◽  
Author(s):  
Paulo Rogério Corrêa Couto ◽  
Rafael do Nascimento Silva ◽  
Rafael de Sousa Carvalho Sabóia ◽  
Airton Vieira Leite Segundo
Keyword(s):  
Postoperative Complications ◽  
General Anesthesia ◽  
Local Anesthesia ◽  
Case Reports ◽  
Inferior Alveolar Nerve ◽  
Image Intensifier ◽  
Dental Practice ◽  
Inferior Alveolar Nerve Block ◽  
Pterygomandibular Space ◽  
Broken Needle

Introduction: Accidents and complications are elements that can occasionally be associated with the procedures realized within work dentist environment. Among some accidents related to dental practice, needle fracture during local anesthesia is noteworthy due to its rarity. Objective: This work seeks to report two cases of removal of a broken dental needle in the pterygomandibular space using an image intensifier. Material and Methods: In both cases, the accident happened during an inferior alveolar nerve block. The surgeons requested image exams to locate the objects using general anesthesia. In the surgery, a transoral incision was made to remove the broken needle from the pterygomandibular space, guided by an image intensifier. Results: Both surgeries were a success. The broken needles were found quickly with the use of the image intensifier, and no postoperative complications were observed. Conclusion: The correct assessment of fractured dental position is essential for its removal. The use of the image intensifier has been showing advantages, such as offering fast transoperative dynamic images and at different angles, thus providing opportunity for calmer surgery and with less risk for the patient and the operator.

scholarly journals RCT on the effectiveness of the intraligamentary anesthesia and inferior alveolar nerve block on pain during dental treatment

2021 ◽  
Author(s):  
Bahaa R. Youssef ◽  
Andreas Söhnel ◽  
Alexander Welk ◽  
Mohamed H. Abudrya ◽  
Mohamed Baider ◽  
...  
Keyword(s):  
Postoperative Complications ◽  
Nerve Block ◽  
Rating Scale ◽  
Dental Treatment ◽  
Inferior Alveolar Nerve ◽  
Numeric Rating Scale ◽  
Inferior Alveolar Nerve Block ◽  
Posterior Teeth ◽  
Mandibular Posterior Teeth ◽  
Numeric Rating

Abstract Objective To compare the effectiveness and complications of intraligamentary anesthesia (ILA) with conventional inferior alveolar nerve block (IANB) during injection and dental treatment of mandibular posterior teeth. Materials and methods In this randomized, prospective clinical trial, 72 patients (39 males, 33 females), scheduled for dental treatment of mandibular posterior teeth, were randomly allocated to ILA group (n = 35) received ILA injection or IANB group (n = 37) received the conventional IANB. Our primary outcome was to assess pain and stress (discomfort) during the injection and dental treatment, using the numeric rating scale (NRS) from 0 to 10 (0 = no pain, 10= the worst pain imaginable), whereas recording 24-h postoperative complications was our secondary outcomes. Results Patients in ILA group reported significantly less pain during injection when compared with IANB group (p = 0.03), while pain during dental treatment was similar in both groups (p = 0.2). Patients in both groups also reported similar law values of discomfort during treatment (p = 0.7). Although no signs of nerve contact or any other postoperative complications were observed, five patients in IANB group (none in ILA group) reported temporary irritations. Conclusion This study showed equivalent effectiveness of both intraligamentary anesthesia and conventional inferior alveolar nerve block, for pain control during routine dental treatment of mandibular posterior teeth. Nevertheless, ILA showed significantly less pain during injection. No major postoperative complications in both groups were observed. Clinical relevance ILA could be considered as an effective alternative for routine dental treatment. Trial registration NCT04563351

A COMPARATIVE EVALUATION OF ANESTHETIC EFFICACY OF 4% ARTICAINE WITH 1:100000 EPINEPHRINE AND 2% LIDOCAINE WITH 1:100000 EPINEPHRINE FOR INFERIOR ALVEOLAR NERVE BLOCK AND LONG BUCCAL NERVE BLOCK DURING ROOT CANAL TREATMENT: AN IN VIVO STUDY

2021 ◽  
pp. 56-59
Author(s):  
Nupur Vasava ◽  
Chintan Joshi ◽  
Vaishali Parekh
Keyword(s):  
Local Anesthesia ◽  
Nerve Block ◽  
Root Canal ◽  
Inferior Alveolar Nerve ◽  
Mean Value ◽  
Root Canal Treatment ◽  
Anesthetic Techniques ◽  
Inferior Alveolar Nerve Block ◽  
The Mean ◽  
Irreversible Pulpitis

Background: It is important to control the pain associated with root canal treatment (RCT) in endodontic. Pain accompanying fear and anxiety due to endodontic treatment can be reduced by anesthetic techniques. The present study aims to compare the effect of articaine versus lidocaine local anesthesia for inferior alveolar nerve block (IANB) and long buccal nerve block on pain during RCT. METHODS: Twenty patients diagnosed with symptomatic irreversible pulpitis of mandibular posterior tooth were selected. The patients randomly received either cartridge of lidocaine or articaine using IANB and long buccal nerve block. The patients were randomly divided into two groups of ten. Group 1: patients received IANB and long buccal nerve block 2% lidocaine with 1:100000 epinephrine. Group 2: patients received IANB and long buccal nerve block with 4% articaine with 1:100000 epinephrine. Before the Injection, the patient received all information about the visual analysis scale (VAS). Pain was evaluated using VAS scale in numberic value 1 to 10 number. The pain was evaluated at three different stages: before administration of LA, after immediate access opening, and after immediate obturation procedure. Data were analyzed using various suitable statistical tests. RESULT: The mean value of efcacy of pain before administration of local anesthesia (LA) was 8.50 ± 0.97 for lidocaine and 8.30 ± 0.48 for articaine had no signicant difference. A signicant difference was observed at two different duration after immediate access opening and after immediate obturation where articaine has a lower mean value 3.60 ± 1.08 and 1.60 ± 0.17 respectively (P>0.05) as compared to the mean value of lidocaine 4.10 ± 1.10 and 1.60 ± 0.17 respectively Conclusion: Within the limitations of the study, in cases of symptomatic irreversible pulpitis articaine 4% did not alleviate pain much and showed better anesthetic efcacy than 2% lidocaine with IANB and long buccal nerve block.

scholarly journals Computer-Controlled Local Anesthesia Complication: Surgical Retrieval of a Broken Dental Needle in Noncooperative Autistic Paediatric Patient

2020 ◽  
Vol 2020 ◽  
pp. 1-5
Author(s):  
Damian Chybicki ◽  
Małgorzata Lipczyńska-Lewandowska ◽  
Gaja Torbicka ◽  
Anna Janas-Naze
Keyword(s):  
Decision Making ◽  
General Anesthesia ◽  
Local Anesthesia ◽  
Unusual Case ◽  
Day Surgery ◽  
Dental Instruments ◽  
Patient Cooperation ◽  
Computer Controlled ◽  
Needle Breakage ◽  
Broken Needle

The article describes an unusual case of retrieval of 8 mm fragment of a broken 30-gauge 21 mm dental needle in a 6 y.o. noncooperative autistic male patient. The needle of a computer-controlled local anesthesia device was broken during an attempt to administer local anesthetic, in order to perform conservative treatment of teeth 55 and 54 by a pedodontist. Despite the fact that the patient was under nitrous oxide sedation, an unexpected movement of the patient occurred and resulted in needle breakage. Due to the lack of patient cooperation, the surgical retrieval of a broken needle was performed under general anesthesia as part of one-day surgery procedures. The purpose of the article is to emphasize careful decision-making in proper choice of dental instruments during treatment of noncooperative paediatric patients even under sedation and to suggest dentists to carry out treatment of such patients under general anesthesia.

Effects of Two Different Anesthetic Solutions on Injection Pain, Efficacy, and Duration of Soft-Tissue Anesthesia with Inferior Alveolar Nerve Block for Primary Molars

2016 ◽  
Vol 40 (6) ◽  
pp. 456-463 ◽  
Author(s):  
Ülkü Şermet Elbay ◽  
Mesut Elbay ◽  
Emine Kaya ◽  
Sinem Yıldırım
Keyword(s):  
Soft Tissue ◽  
Postoperative Complications ◽  
Nerve Block ◽  
Inferior Alveolar Nerve ◽  
Injection Pain ◽  
Primary Tooth ◽  
Inferior Alveolar Nerve Block ◽  
Double Blind ◽  
Mandibular Molars ◽  
Pain Duration

Objectives: The purpose of the study was to compare the efficacy, injection pain, duration of soft tissue anesthesia, and postoperative complications of two different anesthetics (2% lidocaine with 1:80,000 epinephrine and 3% plain mepivacaine) in pediatric patients in inferior alveolar nerve block (IANB) administered by a computer-controlled delivery system (CCDS). Study Design: The study was conducted as a randomized, controlled-crossover, double-blind clinical trial with 60 children requiring bilateral pulpotomy or extraction of primary mandibular molars. A CCDS was used to deliver 3% mepivacaine to 1 primary tooth and 2% lidocaine to the contralateral tooth with an IANB technique. Severity of pain and efficacy of anesthesia were evaluated using the Face, Legs, Activity, Cry, Consolability Scale, and comfort and side effects were assessed using a questionnaire. Data were analyzed using the Mann–Whitney U, Wilcoxon t, and Fisher exact tests. Results: Patients receiving 2% lidocaine experienced significantly less pain during injection than those receiving 3% mepivacaine, and no significant differences were found in the pain scores during treatments or in postoperative complications between the two anesthetics. The mean durations of anesthesia for 3% mepivacaine and 2% lidocaine were 139.68 minutes and 149.10 minutes, respectively. Conclusions: Plain mepivacaine and 2% lidocaine were similarly effective in pulpotomy and the extraction of primary mandibular molars. Although the use of 3% mepivacaine provided a shorter duration of anesthesia than 2% lidocaine, both solutions showed similar results in terms of postoperative complications.

A Clinical Audit into the Success Rate of Inferior Alveolar Nerve Block Analgesia in General Dental Practice

2001 ◽  
Vol os8 (4) ◽  
pp. 139-142 ◽  
Author(s):  
Andrew Keetley ◽  
David R Moles
Keyword(s):  
Facial Nerve ◽  
Success Rate ◽  
Local Anaesthetic ◽  
Nerve Palsy ◽  
Facial Nerve Palsy ◽  
Inferior Alveolar Nerve ◽  
The Other ◽  
Dental Practice ◽  
Inferior Alveolar Nerve Block ◽  
Dental Practitioners

Aims and objectives The aim of this study was to produce some observational evidence of the success rate of inferior alveolar nerve block (IDB) analgesia that is achieved in general dental practice. The objective was to help provide some measure of expected failure rates and help dental practitioners in their self-appraisal of this crucial basic skill. Method Up to 100 consecutive IDB analgesia procedures for four dentists were recorded. In a subdivision of this study 200 consecutive IDBs for a fifth dentist were recorded. This dentist had the greatest experience of giving IDB analgesia of the dentists in this study. In this part of the study the dentist made a note if he anticipated that the procedure would fail. The reason for this was that it was felt that experienced dental practitioners could predict when failure was about to occur. The level of facial nerve palsy was also recorded. Results Overall, 533 of 580 (91.9%) local anaesthetic administrations were deemed to be successful. The only factor that significantly affected the likelihood of success was the practitioner administering the local anaesthetic, and this was only borderline statistically significant. In order to be certain that the other factors did not affect the outcome, the data were re-analysed using the technique of Poisson regression. This technique investigated the effects of each of the factors in turn while controlling for the differences in success that can be attributed to the different practitioners. The regression analyses also did not detect any differences in success that could be attributed to any of the other recorded factors. The incidence of facial palsy was 0.3%. Conclusion This paper gives an insight into the possible success rates to be encountered by general dental practitioners when they administer IDB analgesia. The only recorded factor that could be shown to affect the chance of a successful local analgesic was the operator. The incidence of facial nerve palsy at 0.3% may be more common than has previously been considered.

Variants of inferior alveolar nerve block: A review

2014 ◽  
Vol 6 (1) ◽  
pp. 35-39 ◽  
Author(s):  
Rahul Seth ◽  
M. Anuradha ◽  
D.S. Yashavanth Kumar ◽  
Harsha V. Babji
Keyword(s):  
Success Rate ◽  
Nerve Block ◽  
Inferior Alveolar Nerve ◽  
Dental Practice ◽  
Inferior Alveolar Nerve Block ◽  
Anesthetize Patient ◽  
Mandibular Foramen ◽  
Floor Of The Mouth ◽  
Anaesthetic Solution ◽  
Mandibular Teeth

Abstract The inferior alveolar nerve block is the most common method for obtaining mandibular anaesthesia in dental practice, but it is estimated to have a success rate of only 80 to 85%. Traditional anaesthesia of the mandibular nerve and its branches consists of deposition of anaesthetic solution in the region of the mandibular foramen. This commonly used technique eliminates all somatosensory perception of the mandible, mandibular teeth, floor of the mouth, ipsilateral tongue, and all but the lateral (buccal) gingivae. In the case of difficulty-to-anesthetize patient, the inferior alveolar nerve can be particularly challenging. In those patients, other approaches may be necessary to achieve profound anaesthesia. This article summarizes the different approaches that may be utilized in such cases. How to cite this article Anuradha M, Yashavanth Kumar DS, Harsha VB, Rahul S. Variants of inferior alveolar nerve block. CODS J Dent 2014;6;35-39

Effectiveness of Augmented Reality Mobile Simulator in Teaching Local Anesthesia of Inferior Alveolar Nerve Block

2019 ◽  
Vol 83 (4) ◽  
pp. 423-428 ◽  
Author(s):  
Rasa Mladenovic ◽  
L.A.P. Pereira ◽  
Kristina Mladenovic ◽  
Nebojsa Videnovic ◽  
Zoran Bukumiric ◽  
...  
Keyword(s):  
Augmented Reality ◽  
Local Anesthesia ◽  
Nerve Block ◽  
Inferior Alveolar Nerve ◽  
Inferior Alveolar Nerve Block

Infiltrative local anesthesia with articaine is equally as effective as inferior alveolar nerve block with lidocaine for the removal of erupted molars

2017 ◽  
Vol 21 (3) ◽  
pp. 295-299 ◽  
Author(s):  
J. Venkat Narayanan ◽  
Prashanthi Gurram ◽  
Radhika Krishnan ◽  
Veerabahu Muthusubramanian ◽  
V. Sadesh Kannan
Keyword(s):  
Local Anesthesia ◽  
Nerve Block ◽  
Inferior Alveolar Nerve ◽  
Inferior Alveolar Nerve Block

scholarly journals COMPARISON OF PAIN PERCEIVED BY PATIENTS UNDERGOING INTRA ORAL LOCAL ANESTHESIA USING DIFFERENT NEEDLE GAUGES

2020 ◽  
Vol 70 (6) ◽  
pp. 1702-06
Author(s):  
NoorUlSabah Hussain ◽  
Shoaib Younus ◽  
Uzair Bin Akhtar ◽  
Malik Ali Hassan Sajjad ◽  
Muhammad Salman Chishty ◽  
...  
Keyword(s):  
Local Anesthesia ◽  
Nerve Block ◽  
Oral Surgery ◽  
Maxillofacial Surgery ◽  
Inferior Alveolar Nerve ◽  
Oral And Maxillofacial Surgery ◽  
Inferior Alveolar Nerve Block ◽  
Group A ◽  
The Difference ◽  
Group B

Objective: To compare the difference in pain perceived by patients undergoing intra-oral local anesthesia withdifferent gauge needles. Study Design: Qausi experimental study. Place and Duration of Study: Oral and Maxillofacial surgery department of Institute of Dentistry, CombinedMilitary Hospital, Lahore Medical College, Lahore, from July 2019 to August 2019. Methodology: One hundred patients were selected by consecutive sampling from the oral surgery OPD clinic.They were divided into two groups A and B randomly. Twenty three gauge needle on a 3cc disposable syringewas used for inferior alveolar nerve block and buccal nerve block for group A and 27 gauge needle on a metaldental syringe was used for the same in group B. Patients gave a verbal pain score, from 0-10 for each injection. Results: One Hundred participants were included in study, 37 (37%) males and 63 (63%) females. Mean painscore for group A for the inferior alveolar nerve block was 4.50 ± 2.1 and group B was 3.86 ± 2. The mean painscore for the buccal nerve block in group A was 4.02 ± 1.7, while that of group B was 3.94 ± 1.8. There was nosignificant difference (p=0.167 & 0.855) in pain perceived by patients undergoing intra oral local anesthesia using needles of different gauges. Conclusion: There is no difference in pain perceived by patients undergoing intra oral local anesthesia usingneedles of different gauges.

scholarly journals Effectiveness of Premedication with Analgesics vs Placebo for Success of Inferior Alveolar Nerve Block in Irreversible Pulpitis

2012 ◽  
Vol 2 (1) ◽  
pp. 5-9 ◽  
Author(s):  
Aisha Wali ◽  
Talha Mufeed Siddiqui ◽  
Nauman Qamar ◽  
Rabia Khan ◽  
Nausheen Jawaid
Keyword(s):  
Success Rate ◽  
Local Anesthesia ◽  
Nerve Block ◽  
Naproxen Sodium ◽  
Inferior Alveolar Nerve ◽  
Endodontic Treatment ◽  
Inferior Alveolar Nerve Block ◽  
Female Patients ◽  
Experienced Pain ◽  
Irreversible Pulpitis

ABSTRACT Pain is considered to be the major cause for seeking emergency endodontic treatment. Pain management is of vital importance in endodontics with no exception. Local anesthesia is considered to be the primary method to control pain. An effective local anesthesia cannot be obtained if pulp is inflamed. Clinician prescribes nonsteroidal anti-inflammatory drugs (NSAIDs) as premedication on a routine basis for mild to moderate pain to reduce pulpal inflammation before injecting anesthesia. These drugs are beneficial in providing relief from pain and inflammation in irreversible pulpitis and helps in providing effectiveness of inferior alveolar nerve block. Moreover, they have a short half life, which would make them ideal for a single dosage prior to the management of severe pain. Aim To conduct a randomized-placebo controlled clinical trial to compare the effectiveness of premedication with analgesics vs placebo for success of inferior alveolar nerve block in irreversible pulpitis. Materials and methods The study consisted of 80 adult patients attending operative Outpatient Department in Baqai Dental College. Informed Consent was obtained from each participant. Subjects were randomly divided in four groups comprising of 20 subjects in each group. Group A received piroxicam (Feldene 20 mg, Pfizer), group B received diclofenac potassium (Fastaid Plus, 50 mg platinum pharmaceutic), group C received naproxen sodium (Synflex 550 mg, ICI), and group D received a placebo drug becefol (Abbott). Medication was given 1 hour before initiating endodontic treatment. After 1 hour of oral administration of tablets, inferior alveolar nerve block using 1.8 ml of 2% lidocaine containing 1: 200,000 epinephrine was given. After 15 minutes, access cavity preparation was initiated and patients were asked to inform if they experienced pain. Patients were excluded from the study if they experienced pain but if the patient did not feel pain endodontic treatment was continued. p-value was set at 0.05. Data was analyzed by using Chi-square test (SPSS 19). Results The result showed that out of 80 patients who participated in the study, success rate for piroxicam came out to 90% (10 male and 8 female patients), followed by diclofenac potassium with 75% success rate (9 male and 6 female patients), naproxen sodium with 35% success rate (3 male and 4 female patients) and placebo with 10% success (1 male and 1 female patient). Conclusion The current study concludes that premedication given 1 hour before injecting anesthesia is helpful in reducing pain intensity and thus causing inferior alveolar nerve block to be effective. How to cite this article Wali A, Siddiqui TM, Qamar N, Khan R, Jawaid N. Effectiveness of Premedication with Analgesics vs Placebo for Success of Inferior Alveolar Nerve Block in Irreversible Pulpitis. Int J Prosthodont Restor Dent 2012;2(1):5-9.

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