Comparison of anesthetic efficacy of intraosseous injection with conventional inferior alveolar nerve block in mandibular third molar surgery: a systematic review and meta-analysis

Kc, Kumar; Bhattarai, Bishwa Prakash; Subedi, Sushil

doi:10.1016/j.oooo.2021.07.020

Cited by 3 publications

(3 citation statements)

References 16 publications

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“…The fact that the failure rate of conventional IANB is high [ 33 ] may be related to this discrepancy. A meta-analysis showed that intraosseous injection with buccal infiltration anesthesia is more effective than conventional IANB alone for mandibular molar pulpitis [ 34 , 35 ] and that the duration of anesthetic effect is shorter [ 36 ]. Thus, intraosseous anesthesia is likely to be effective within the mandible and may be effective for pain caused by drilling but not for prolongation of the anesthetic effect.…”

Section: Pain Control By Local Anesthesia For Implant Surgerymentioning

confidence: 99%

Considerations for Satisfactory Sedation during Dental Implant Surgery

Ito

Utsumi

Baba

et al. 2023

JPM

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Implant surgery is a lengthy dental procedure, and sedation is often used to reduce discomfort. The effectiveness of sedation has traditionally been evaluated in terms of patient and surgeon satisfaction, but the most important goal is not to induce a deep sleep in the patient, but rather to ensure that the surgery is performed safely and as planned. Additionally, adequate pain control is a necessary requirement for patient and surgeon satisfaction. Most patients undergoing implant surgery are middle-aged or older, and a relatively large number of them have cardiovascular disease. Infiltration anesthesia using articaine or lidocaine in combination with adrenaline is widely used, but its use in patients with cardiovascular disease is limited because of adrenaline’s effects on the cardiovascular system. The use of long-acting local anesthetics and the potential efficacy of ultrasound-guided jaw nerve block have been investigated to enhance analgesia without resorting to adrenaline. Midazolam and propofol are usually used for sedation, but dexmedetomidine, which causes less respiratory depression, and the ultrashort-acting benzodiazepine remimazolam are emerging as potential alternatives. Monitoring of anesthetic depth using electroencephalography is effective in maintaining a constant level of sedation. In addition, sedation promotes the stabilization of heart rate and blood pressure, reducing the risks associated with adrenaline and allowing for safer management.

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Section: Pain Control By Local Anesthesia For Implant Surgerymentioning

confidence: 99%

Considerations for Satisfactory Sedation during Dental Implant Surgery

Ito

Utsumi

Baba

et al. 2023

JPM

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“…It can achieve deep anesthesia without numbness of the lip and cheek tissue and is mainly used in root canal practice. Intraosseous anesthesia can significantly enhance the effect of pulp anesthesia in patients with irreversible pulpitis and can be used for supplementary anesthesia after the failure of IANB alone ( Dias-Junior et al, 2021 ; Kc, Bhattarai & Subedi, 2022 ; Zanjir et al, 2019 ). The continuous improvement of intraosseous anesthesia equipment is receiving increasing attention due to its good anesthesia effect, minimal invasiveness, simple operation, and easy control ( Sovatdy et al, 2018 ).…”

Section: How To Minimize Injection Painmentioning

confidence: 99%

Physiology of pregnancy and oral local anesthesia considerations

Zhou

Zhong

Pan

et al. 2023

PeerJ

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Background Safe and effective local anesthesia is a prerequisite for emergency oral surgeries and most dental treatments. Pregnancy is characterized by complex physiological changes, and increased sensitivity to pain. Pregnant women are particularly vulnerable to oral diseases, such as caries, gingivitis, pyogenic granuloma and third molar pericoronitis. Maternally administered drugs can affect the fetus through the placenta. Therefore, many physicians and patients are reluctant to provide or accept necessary local anesthesia, which leads to delays in the condition and adverse consequences. This review is intended to comprehensively discuss the instructions for local anesthesia in the oral treatment of pregnant patients. Methodology An in-depth search on Medline, Embase, and the Cochrane Library was performed to review articles concerned with maternal and fetal physiology, local anesthetic pharmacology, and their applications for oral treatment. Results Standard oral local anesthesia is safe throughout the pregnancy. At present, 2% lidocaine with 1:200,000 epinephrine is considered to be the anesthetic agent that best balances safety and efficacy for pregnant women. Maternal and fetal considerations must be taken into account to accommodate the physiological and pharmacological changes in the gestation period. Semi-supine position, blood pressure monitoring, and reassurance are suggested for high-risk mothers to reduce the risk of transient changes in blood pressure, hypoxemia, and hypoglycemia. For patients with underlying diseases, such as eclampsia, hypertension, hypotension, and gestational diabetes, the physicians should use epinephrine cautiously and control the dose of anesthetic. New local anesthesia formulations and equipment, which contribute to minimizing injection pain and relieving the anxiety, have and are being developed but remain understudied. Conclusions Understanding the physiological and pharmacological changes during pregnancy is essential to ensure the safety and efficiency of local anesthesia. Optimal outcomes for the mother and fetus hinge on a robust understanding of the physiologic alterations and the appropriate selection of anesthetic drugs and approaches.

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“…Although intraosseous anaesthesia offers several advantages (no soft tissue numbness occurs, short duration of anaesthesia and relatively little anaesthetic solution is needed), the question to use it as a supplemental or an alternative technique to IANB still remains controversial regarding the success rate. A recent meta‐analysis concluded that the anaesthetic efficacy was similar between IANB and intraosseous anaesthesia for mandibular third molar surgery (Kumar et al, 2022). Another meta‐analysis in case of SIP, concluded that intraosseous anaesthesia given after the failure of primary IANB, increases the overall anaesthetic efficacy (Gupta et al, 2021).…”

Section: Introductionmentioning

confidence: 99%

Comparing intraosseous computerized anaesthesia with inferior alveolar nerve block in the treatment of symptomatic irreversible pulpitis: A randomized controlled trial

Gaudin,

Clouet,

Boëffard

et al. 2023

Int Endodontic J

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Aim The aim of this study was to compare the cardiovascular effects [heart rate, oxygen saturation (SpO2), systolic and diastolic blood pressure] and the anaesthetic efficacy of intraosseous computerized anaesthesia (ICA) versus inferior alveolar nerve block (IANB) in Symptomatic irreversible pulpitis (SIP). Methodology The study protocol was registered with http://clinicaltrials.gov (NCT03802305). In a randomized, prospective clinical trial, 72 mandibular molar teeth with SIP were randomly allocated to conventional IANB injection (n = 36) or ICA injection (n = 36), both with 1.8 mL of 4% articaine with 1:100 000 epinephrine. The primary objective was to assess the cardiovascular parameters (heart rate, oxygen saturation, blood pressure) before, during and after the anaesthesia. The secondary objectives were to compare ICA with IANB for success and postoperative outcomes for up to 3 days. Results The maximum increase in heart rate in the ICA group was greater than in the IANB. Other cardiovascular parameters did not show differences throughout the clinical procedure. There were no statistically significant differences (p > .05) between groups for sex, age, or anxiety. The total success rate of ICA (91.43%) was significantly higher (p = .0034) than that of IANB (69.44%). Conclusions This study establishes that ICA is safe and efficient in the first intention for the treatment of SIP of the mandibular molar.

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Comparison of anesthetic efficacy of intraosseous injection with conventional inferior alveolar nerve block in mandibular third molar surgery: a systematic review and meta-analysis

Cited by 3 publications

References 16 publications

Considerations for Satisfactory Sedation during Dental Implant Surgery

Considerations for Satisfactory Sedation during Dental Implant Surgery

Physiology of pregnancy and oral local anesthesia considerations

Comparing intraosseous computerized anaesthesia with inferior alveolar nerve block in the treatment of symptomatic irreversible pulpitis: A randomized controlled trial

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