scholarly journals Bifid mandibular canal: a rare or underestimated entity?

2016 ◽  
Vol 6 (3) ◽  
Author(s):  
Ibrahim Nasseh ◽  
Georges Aoun
Keyword(s):  
Nerve Block ◽  
Inferior Alveolar Nerve ◽  
Radiographic Finding ◽  
Anatomical Variations ◽  
Mandibular Canal ◽  
Inferior Alveolar Nerve Block ◽  
The Third ◽  
Bifid Mandibular Canal ◽  
Mandibular Molar ◽  
Surgical Extraction

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.

Pain assessment after application of 4% articaine with epinephrine 1:100000 during mandibular dental procedures

2021 ◽  
Vol 12 (46) ◽  
pp. 76-80
Author(s):  
Adel Martínez-Martínez ◽  
Samuel Urbano del Valle ◽  
Johnatan Zambrano Trespalacios
Keyword(s):  
Nerve Block ◽  
Inferior Alveolar Nerve ◽  
Latency Period ◽  
Anesthetic Technique ◽  
Dental Practice ◽  
Inferior Alveolar Nerve Block ◽  
Dental Procedures ◽  
Mandibular Molar ◽  
The University ◽  
Buccal Infiltration

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.

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

2021 ◽  
Author(s):  
Subashri V ◽  
Nivedha V ◽  
Anand Sherwood ◽  
Paul Abbott ◽  
James L Gutmann ◽  
...  
Keyword(s):  
Laser Irradiation ◽  
Nerve Block ◽  
Inferior Alveolar Nerve ◽  
Inferior Alveolar Nerve Block ◽  
Pulp Tissue ◽  
Pain Scores ◽  
Group I ◽  
Post Operative Pain ◽  
Mandibular Molar ◽  
Molar Teeth

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.

scholarly journals Failure rate of pterygomandibular block in lower third molar extraction procedures

2018 ◽  
Vol 7 (9) ◽  
Author(s):  
María del Pilar Rodríguez Sánchez ◽  
Jadison Junio Conforte ◽  
João Paulo Bonardi ◽  
Débora Bressan Galafassi ◽  
Daniela Ponzoni
Keyword(s):  
Failure Rate ◽  
Nerve Block ◽  
Surgical Procedures ◽  
Inferior Alveolar Nerve ◽  
Third Molar ◽  
Anatomical Variations ◽  
Inferior Alveolar Nerve Block ◽  
Extraction Procedures ◽  
Third Molar Extraction ◽  
Molar Extraction

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.

scholarly journals Effect of Preoperative Pain on Inferior Alveolar Nerve Block

2015 ◽  
Vol 62 (4) ◽  
pp. 135-139 ◽  
Author(s):  
Vivek Aggarwal ◽  
Mamta Singla ◽  
Arunajatesan Subbiya ◽  
Paramasivam Vivekanandhan ◽  
Vikram Sharma ◽  
...  
Keyword(s):  
Nerve Block ◽  
Inferior Alveolar Nerve ◽  
Double Blind Study ◽  
Inferior Alveolar Nerve Block ◽  
Success Rates ◽  
Preoperative Pain ◽  
Double Blind ◽  
Mandibular Molar ◽  
Significant Difference ◽  
Irreversible Pulpitis

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.

Study of the Anesthetic Efficacy of Inferior Alveolar Nerve Block using Articaine in Irreversible Pulpitis

2014 ◽  
Vol 15 (1) ◽  
pp. 71-74 ◽  
Author(s):  
Zeeshan H Ahmad ◽  
H Ravikumar ◽  
Rupali Karale ◽  
RS Preethanath ◽  
Anil Sukumaran
Keyword(s):  
Nerve Block ◽  
Visual Analog Scale ◽  
Inferior Alveolar Nerve ◽  
Inferior Alveolar Nerve Block ◽  
Analog Scale ◽  
Cavity Preparation ◽  
The Third ◽  
Group 2 ◽  
Buccal Infiltration ◽  
Irreversible Pulpitis

ABSTRACT Aim The purpose of this study was to determine the anesthetic efficacy of inferior alveolar nerve block (IANB) using 4% articaine and 2% lidocaine supplemented with buccal infiltration. Materials and methods Forty five patients, diagnosed with irreversible pulpitis of a mandibular posterior tooth were included in the study. The first group of 15 patients received 2% lidocaine with 1:200000 epinephrine, the second group 2% lidocaine with 1: 80,000 epinephrine and the third group of 15 subjects received 4% articaine with 1:100000 epinephrine. During the access cavity preparation those patients who complained of pain received an additional buccal infiltration. The percentage of subjects who got profound anesthesia and failure to achieve anesthesia were calculated and tabulated using a visual analog scale. Results The results revealed that 87% of subjects who received 4% Articaine with 1:100,000 epinephrine got satisfactory anesthesia with inferior alveolar nerve block alone. Only 2 (13%) subjects received an additional buccal infiltration and none of the patients failed to obtain complete anesthesia with articaine. In comparison only 40% of subjects got complete anesthesia with 2% lidocaine with 1:200000 and 60% with 2% lidocaine with 1:80,000. Conclusion It can be concluded that 4% articaine can be used effectively for obtaining profound anesthesia for endodontic procedures in patients with irreversible pulpitis. How to cite this article Ahmad ZH, Ravikumar H, Karale R, Preethanath RS, Sukumaran A. Study of the Anesthetic Efficacy of Inferior Alveolar Nerve Block using Articaine in Irreversible Pulpitis. J Contemp Dent Pract 2014;15(1):71-74.

scholarly journals A comparative clinical study to evaluate the effectof premedication with Ibuprofen, Tramadol and combination of Ibuprofen and Acetaminophen on success of Inferior Alveolar Nerve Block in patients with Asymptomatic Irreversible Pulpitis.

2017 ◽  
Vol 16 (3) ◽  
pp. 370-374 ◽  
Author(s):  
Pardeep Mahajan ◽  
Gurbant Singh ◽  
Roopinder Kaur ◽  
Prashant Monga ◽  
Vanita ◽  
...  
Keyword(s):  
Clinical Study ◽  
Success Rate ◽  
Nerve Block ◽  
Medical Science ◽  
Inferior Alveolar Nerve ◽  
Inferior Alveolar Nerve Block ◽  
Double Blind ◽  
Radiographic Findings ◽  
Mandibular Molar ◽  
Irreversible Pulpitis

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

scholarly journals Variant root morphology of third mandibular molar in normal and impacted teeth

2017 ◽  
Vol 6 (3) ◽  
pp. 1052-1061
Author(s):  
Isaac Kipyator Bokindo ◽  
Fawzia Butt ◽  
Francis Macigo
Keyword(s):  
Root Morphology ◽  
Inferior Alveolar Nerve ◽  
Third Molar ◽  
Mandibular Canal ◽  
Impacted Teeth ◽  
The Third ◽  
Mandibular Third Molar ◽  
Mandibular Molar ◽  
Panoramic Views

The mandibular third molar poses a challenge to dental surgeons due to it’s unpredictable morphology which leads to increased difficulty during its extraction. The root morphology of the third molar is considered to be the most variable in the human dentition. The study aims to document these variations which will be useful while undertaking procedures on the third molar. Three hundred and fifty nine panoramic views of the mandible were obtained from the Radiology division for patients seeking treatment in the School of Dental Sciences since 2010. The prevalence of third molar impaction was found to be 27%, with mesioangular being the commonest at 21.9% using the Winter’s classification. Dilacerations of roots was recorded at 44%, with a ratio of normal to dilacerated of 1:1 seen in impacted teeth while, non impacted teeth had a ratio of 1.3:1. Most teeth had 2 roots (85.5%), with one root seen in 12.1%. Partially fused roots was also observed in 2.4% of cases with only one case showing three roots. The total mean distance from the tips of roots to the mandibular canal was -0.5mm. Higher negative means of -1.5mm was recorded in impacted teeth than in normal teeth (-0.2mm). Teeth with dilacerated roots also showed closer proximity to mandibular canal than straight rooted teeth. The left side of the jaw also showed higher negative means. Present findings suggest that careful considerations should be made on impacted teeth. In addition to the type of impaction, proximity to the inferior alveolar nerve (IAN), number of roots and shape of the roots should be assessed. Similar considerations should also be made to non impacted teeth due to the high unpredictability observed in root morphology.Keywords: Third molar, root morphology, impaction

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