Intraseptal vs. periodontal ligament anaesthesia for maxillary tooth extraction: quality of local anaesthesia and haemodynamic response

Abstract

There is no data concerning the use of the intraseptal anaesthesia (ISA) for single tooth extraction. The aims of this study were to compare the clinical efficacy and haemodynamic responses of the ISA with the periodontal ligament anaesthesia (PLA) for single tooth extraction. Thirty-five randomly selected healthy patients (ASA I) undergoing maxillary lateral incisors extraction entered the study. Onset of anaesthesia, the width of the anaesthetic field and duration of anaesthesia were recorded by pinprick testing. Intensity of anaesthesia was evaluated on a visual analogue scale. Haemodynamic parameters were recorded simultaneously at different time points after anaesthesia injection. The two techniques of local anaesthesia did not show statistically significant differences regarding the success rate and onset of anaesthesia, while the duration of the ISA on the buccal site was significantly longer in comparison with the PLA. The intensity of the achieved anaesthesia, estimated by the experienced pain during procedure, pointed out that pain was recorded in 24% of cases in the ISA group, and in 19% in the PLA group without significant differences. Postoperative pain was found to be smaller in the ISA group (70.9% of treated sites) than in the PLA group (81.3% of treated sites); however, this difference was not significant. Although the heart rate increased in both groups, there were no significant differences in the patients' haemodynamic response between the ISA and the PLA. The results of the present study indicate that both techniques are useful and suitable for the routine tooth extraction.

Clinical evaluation of different epinephrine concentrations for local dental anesthesia

“…However, factors such as inadequate choice of anesthetic solution, anesthetic salt overdose, accidental vasoconstrictor intravascular injection and fast administration of the solution may lead to increased blood concentration of the drug and to a higher potential for toxic effects 1,2 . Systemic complications of intravascular injection of local an-esthetics are basically induced by the interaction of adrenergic vasoconstrictors and sympathetic autonomous nervous system receptors, because its vasoconstrictor therapeutic action occurs by means of binding to α1 receptors.…”

Holter ECG assessment of the effects of three different local anesthetic solutions on cardiovascular system in the sedated dental patients with coronary artery disease

“…Niwa et al (27,28), showed that infiltration anesthesia for dental use with 3.6 mL of lidocaine with 1:80.000 epinephrine could be carried out safely on the patients who have exercise capacity of more than 4 metabolic equivalents. Brkovic et al (29) found no significant differences in the patients' hemodynamic response with lidocaine with epinephrine concerning the use of local anesthetic injection for single tooth extraction. Our results showed similarity to those by Perusse et al (17,20), who reported that the use of epinephrinecontaining local anesthetics in dental patients with coronary atherosclerosis could show significant hemodynamic changes and lead to life threatening complications.…”

The impact of cardiovascular drugs on the efficacy of local anesthesia in dentistry

“…Local clinical parameters of anesthesia were monitored only in healthy subjects through comparative analysis of two different anesthetics given by the same anesthetic technique or two different anesthetic techniques using the same anesthetic 12,13 . Two in vitro studies have recently demonstrated that antihypertensives propranolol and verapamil cause local anesthesia 14,15 .…”