Periodontal Ligament Injection: A Clinical Evaluation

Walton, Richard E.; Abbott, Bernard J.

doi:10.14219/jada.archive.1981.0307

Cited by 116 publications

(64 citation statements)

References 6 publications

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“…It has limitations as a principal method of anaesthesia (such as variable duration) but has been used to overcome failed conventional methods. 9,10 The technique is equally effective with conventional or specialised syringes. Glass cartridges are used in this method as the plastic type deform under the pressures produced.…”

Section: Intraligamentary Anaesthesiamentioning

confidence: 99%

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How to overcome failed local anaesthesia

Meechan

1999

Br Dent J

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Local anaesthetic failure is an unavoidable aspect of dental practice. A number of factors contribute to this, which may be related to either the patient or the operator. Patient-dependent factors may be anatomical, pathological or psychological. This paper considers the reasons for unsuccessful dental local anaesthetic injections and describes techniques which may be useful in overcoming failure. How to overcome failed local anaesthesia J. G. Meechan 1 This paper:q Explains the reasons for local anaesthetic failure q Describes injection techniques to overcome failure q Offers a rational approach to the failed local anaesthetic case PRACTICE anaesthesia

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Section: Intraligamentary Anaesthesiamentioning

confidence: 99%

“…A 12 mm 30 gauge is recommended although efficacy is independent of needle diameter. 9,10 Ideally the bevel should face the bone although effectiveness is not impaired with different orientations. 12 The needle does not penetrate deeply into the periodontal ligament but is wedged at the crest of the alveolar ridge.…”

Section: Intraligamentary Anaesthesiamentioning

confidence: 99%

How to overcome failed local anaesthesia

Meechan

1999

Br Dent J

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“…Induction of effective anesthesia and successful management of postoperative pain may be especially challenging for endodontic treatment of teeth with pulpitis (5). Walton et al (6) reported that lower molar teeth were the most difficult for provision of anesthesia in 47% of cases. Malamed (7) performed a similar study at the University of Southern California, and found that sufficient pulpal anesthesia for lower molars was difficult in 91% of cases.…”

Section: Introductionmentioning

confidence: 99%

The effect of orally administered ketamine on requirement for anesthetics and postoperative pain in mandibular molar teeth with irreversible pulpitis

et al. 2011

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Achieving successful anesthesia and pain control in a predictable, efficient manner is a challenge in the endodontic treatment of vital inflamed lower molars. The aim of this study was to evaluate the effect of oral ketamine on the dosage of local anesthetics required and postoperative pain management for irreversibly inflamed mandibular molars. In this randomized double-blind placebocontrolled clinical trial, 36 patients with irreversibly inflamed mandibular molars were randomly divided into two groups of 18. Ten mg of ketamine dissolved in 20 ml of fruit juice was administered orally to patients in the experimental group. The control group was given 20 ml of fruit juice alone as a placebo. After 30 min, inferior alveolar nerve block (IANB) anesthesia was induced using one cartridge of 2% lidocaine and 1:100000 epinephrine. Teeth were tested after 5 to 10 min using an electrical pulp tester. In patients showing a positive response, another IANB injection was applied, and the total number of anesthetic cartridges used was recorded. Postoperative pain was evaluated using a visual analogue scale (VAS). In addition, use of analgesic in the first 24 h after treatment was monitored using a questionnaire. Data were analyzed by t test using SPSS software. There were no significant differences in age or gender between the two groups. The number of anesthetic cartridges used in the ketamine group was significantly less than that in the control group (P = 0.003). Furthermore, postoperative pain in the ketamine group was significantly lower (P = 0.019). Also the number of analgesic tablets taken in the ketamine group was significantly lower (P = 0.011). It can be concluded that a low dose of ketamine might be beneficial for enhancing the effect of local anesthetics. (J Oral Sci 53, 461-465, 2011)

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“…Nos tecidos inflamados, a falha em obter alívio satisfatório da dor clínica é bem conhecida. Também deve ser mencionado que os exsudatos inflamatórios podem inibir a anestesia local diretamente através do estimulo da condução nervosa 6,7 . Para alcançar efetividade anestésica nestes pacientes, muitos cirurgiões-dentistas lançam mão de técnicas anestésicas complementares, entre elas a injeção direta do anestésico no ligamento periodontal (técnica intraligamentar).…”

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Comparação da Eficácia Anestésica da Articaína e da Lidocaína em Extrações de Dentes com Periodontite Crônica Avançada

RIBEIRO¹

2012

Pesqui. bras. odontopediatria clín. integr.

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Objetivo: Avaliar a eficácia anestésica e a necessidade de complementação de anestesia por técnica intraligamentar em pacientes portadores de periodontite crônica avançada após técnica anestésica de bloqueio dos nervos alveolar inferior, lingual e bucal com o uso de duas soluções anestésicas diferentes. Método: Foram selecionados 30 pacientes com periodontite crônica avançada com indicação para exodontia em pelo menos dois dentes inferiores, um em cada lado da mandíbula. 60 bloqueios anestésicos foram realizados em sessões distintas com intervalo de uma semana entre as sessões sendo: 30 bloqueios com articaína 4% com epinefrina 1:100.000 e 30 bloqueios com lidocaína 2% com epinefrina 1:100.000. A sensibilidade dolorosa foi medida por meio de uma escala analógica de faces em que os pacientes classificavam a dor sentida em escores que variavam de 0 (ausência de dor) a 5 (dor severa) sendo que, escores superiores a 2 após a anestesia, indicavam a necessidade de complementação anestésica intraligamentar. O teste estatístico de Mann-Whitney foi utilizado para comparar a efetividade anestésica e a necessidade de técnica complementar e os resultados foram considerados estatisticamente significantes quando p < 0,05. Resultados: Na comparação do sucesso anestésico das duas soluções, verificou-se uma diferença estatisticamente significante (p = 0,0337), assim como, na necessidade de técnica anestésica complementar (anestesia intraligamentar), onde apenas 16,7% dos pacientes anestesiados com articaína necessitaram do complemento anestésico. Com a solução de lidocaína essa porcentagem aumentou para 46,7%, mostrando a superioridade da articaína 4% com epinefrina 1:100.000. Conclusão: A articaína 4% com epinefrina 1:100.000 obteve melhor desempenho que a lidocaína 2% com epinefrina 1:100.000 tanto no quesito sucesso anestésico quanto na necessidade de anestesia complementar intraligamentar.Articaina; Lidocaina; Periodontite.Objective: To evaluate the anesthetic efficacy and the need for additional intraligamentary anesthesia in patients with advanced chronic periodontitis after anesthesic block for inferior alveolar nerve, lingual and buccal using two different anesthesics. Method: We selected 30 patients with advanced chronic periodontitis and with indication for extraction of at least two lower teeth, one on each side of the mandible. 60 anesthesic blocks performed in two sessions with one week between sessions: 30 blocks of articaine 4% with epinephrine 1:100,000 and 30 blocks of lidocaine 2% with epinephrine 1:100,000. The pain was measured using a faces analogue scale in which patients rated the pain felt in scores ranging from 0 (no pain) to 5 (hard pain) and, scores higher than 2 in moment post anesthesia, indicated the need for intraligamentary supplementary anesthesia. The statistical test of Mann-Whitney was used to compare the anesthetic efficacy and the need for additional anesthesia and the results were considered statistically significant when p < 0.05. Results: When comparing the success of the two anesthetic s...

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Periodontal Ligament Injection: A Clinical Evaluation

Cited by 116 publications

References 6 publications

How to overcome failed local anaesthesia

How to overcome failed local anaesthesia

The effect of orally administered ketamine on requirement for anesthetics and postoperative pain in mandibular molar teeth with irreversible pulpitis

Comparação da Eficácia Anestésica da Articaína e da Lidocaína em Extrações de Dentes com Periodontite Crônica Avançada

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