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At least 343 records · Page 19Linked to original sources
PubMed2006

The significance of needle bevel orientation in achieving a successful inferior alveolar nerve block.

BACKGROUND: The authors conducted a prospective, randomized, single-blinded, crossover study comparing the degree of pulpal anesthesia achieved with the use of a conventional inferior alveolar nerve (IAN) block administered with the needle bevel oriented away from the mandibular ramus or toward the mandibular ramus. METHODS: Fifty-one blinded subjects randomly received an IAN block injection administered with a 27-gauge needle; the needle bevel was oriented away from the mandibular ramus or oriented toward the mandibular ramus at appointments spaced at least one week apart, in a crossover design. The authors used a pulp tester to test molars, premolars and central and lateral incisors for anesthesia in four-minute cycles for 60 minutes. They considered anesthesia to be successful when two consecutive 80 readings (the maximum output on the pulp tester) were obtained within 15 minutes, and the 80 reading was sustained continuously for 60 minutes. RESULTS: When the needle bevel was oriented away from the mandibular ramus, successful pulpal anesthesia from the central incisor to the second molar was achieved in 24 to 90 percent of patients. When the needle bevel was oriented toward the mandibular ramus, successful pulpal anesthesia was achieved in 14 to 92 percent of patients. The results showed no significant difference between the two needle bevel orientations. CONCLUSION: The authors concluded that using a 27-gauge needle with the bevel oriented away from the mandibular ramus was similar to using the same needle with the bevel oriented toward the mandibular ramus to administer successful IAN blocks in adults. CLINICAL IMPLICATIONS: For IAN blocks administered with a 27-gauge needle, positioning the needle bevel away or toward the mandibular ramus does not affect anesthetic success.

Adult↗
PubMed2002

Anesthetic efficacy of an infiltration in mandibular anterior teeth following an inferior alveolar nerve block.

The purpose of this prospective, randomized, blinded study was to measure the degree of pulpal anesthesia obtained with an inferior alveolar nerve (IAN) block followed by an infiltration in mandibular anterior teeth. Through use of a repeated-measures design, 40 patients randomly received 3 injection combinations at 3 separate appointments: an IAN block followed by a mock lingual infiltration and a mock labial infiltration, an IAN block followed by a mock lingual infiltration and a labial infiltration, and an IAN block followed by a mock labial infiltration and a lingual infiltration. Each IAN block used 3.6 mL of 2% lidocaine with 1:100,000 epinephrine, and each infiltration used 1.8 mL of 2% lidocaine with 1:100,000 epinephrine administered over the lateral incisor apex. Mandibular anterior teeth were blindly pulp tested at 2-minute cycles for 60 minutes following the IAN-infiltration injections. No response from the patient to the maximum output (80 reading) of the pulp tester was used as the criterion for pulpal anesthesia. Anesthesia was considered successful when 2 consecutive 80 readings were obtained within 15 minutes and the 80 reading was sustained for 60 minutes. Anesthesia was considered a failure if 2 consecutive 80 readings were not obtained during the 60 minutes. The results of this study showed that 100% of the patients had lip numbness with all IAN blocks. For the lateral incisor, the success rate of the IAN block alone was 40% and the failure rate was 30%. For the IAN block plus labial infiltration, the success rate was 62% and the failure rate was 12% for the lateral incisor. There was a significant difference (P < .05) between the IAN block alone and the IAN block plus labial infiltration. In conclusion, a labial infiltration, over the lateral incisor apex, of 1.8 mL of 2% lidocaine with 1:100,000 epinephrine following an IAN block significantly improved pulpal anesthesia for the lateral incisor compared with the IAN block alone.

Adult↗
PubMed1998

Anesthetic efficacy of the intraosseous injection of 0.9 mL of 2% lidocaine (1:100,000 epinephrine) to augment an inferior alveolar nerve block.

OBJECTIVE: The purpose of this study was to determine the anesthetic efficacy of an intraosseous injection of 0.9 mL of 2% lidocaine with 1:100,000 epinephrine to augment an inferior alveolar nerve block in mandibular posterior teeth. STUDY DESIGN: With the use of a repeated-measures design, each of 38 subjects randomly received one or the other of 2 combinations of injections at 2 separate appointments. The combinations were inferior alveolar nerve block + intraosseous injection (on the distal of the second premolar) through use of 0.9 mL of 2% lidocaine with 1:100,000 epinephrine and inferior alveolar nerve block + mock intraosseous injection. The first molar, second premolar, and second molar were blindly tested with an Analytic Technology pulp tester at 2-minute cycles for 120 minutes postinjection. Anesthesia was considered successful when 2 consecutive 80 readings were obtained. RESULTS: One hundred percent of the subjects had lip numbness with the inferior alveolar nerve block + intraosseous injection combination technique. The respective anesthetic success rates for the inferior alveolar nerve block + mock intraosseous injection combination and the inferior alveolar nerve block + intraosseous injection combination were 60% and 100% for the second premolar, 71% and 95% for the first molar, and 74% and 87% for the second molar. The differences were significant (P < .05) for the second premolar through 50 minutes and for the first molar through 20 minutes. There were no significant (P > .05) differences for the second molar. Sixty-eight percent of the subjects had a subjective increase in heart rate with the intraosseous injection. CONCLUSIONS: The results of this study indicate that the supplemental intraosseous injection of 0.9 mL of 2% lidocaine with 1:100,000 epinephrine, given distal to the second premolar, significantly increased the success of pulpal anesthesia in the second premolar (for 50 minutes) and first molar (for 20 minutes) in comparison with the inferior alveolar nerve block alone. The intraosseous injection did not statistically increase success in the second molar.

Adolescent↗
PubMed1994

Encoding of the subjective intensity of sharp dental pain.

This paper is a review and a discussion of our own pain research over the last decade. It is of a methodological and theoretical character and deals with preparation technique, choice of electrodes, control experiments involving pulpotomy and reliability tests of psychophysical methods for pain measurements, and the neuronal population encoding of sharp dental pain. The electrophysiological recording technique selectively picks up electrical activity induced in pulpal A-delta nerve fibers. The sensation of pain was quantified by means of an intermodal matching technique, finger span (PAS), in combination with sensory verbal descriptors covering a range from very, very weak to maximal pain. When a cold stimulus, ethyl chloride, was applied on the tooth surface a close agreement was demonstrated between intradental A-delta nerve activity (INA) and the sensation magnitude of pain (PAS) with respect to curve amplitude and time course. The high covariation of the neural and perceptual response measures indicated a good internal validity and confirmed also the basic soundness and the applicability of the procedures employed. For the purpose of further analyzing the functional relation of INA to PAS we studied specifically the effect of cold stimuli of different intensity on the integrated nerve response. Only sharp, shooting pain was accepted as a sensorial, perceptual correlate of the intradental A-delta nerve activity. Since an increase in amplitude was generally accompanied by an increase in duration of the responses, the fundamental question was raised how to best describe and characterize the neural and perceptual responses so that they most adequately reflect the information processing of the intensive aspect of sharp dental pain.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1991

In situ testing of CO2 laser on dental pulp function: effects on microcirculation.

The effect of CO2 laser irradiation on pulpal microcirculation was studied in cat canines. The enamel surfaces of 4 teeth were exposed with energy densities of 304-1440J/cm2, using either a handpiece or a microslad, with a focal spot of 0.21mm and 0.33mm respectively. Pulpal blood flow (PBF) before and following lasing was recorded through the intact tooth surface by a laser Doppler flowmeter. CO2 laser irradiation caused an increase in PBF, which was immediate and transient. The PBF increase was higher in a large pulp than in a small pulp, and it was inversely related to the focal spot size. These findings confirm that the dental pulp is thermally affected by CO2 lasing of the tooth surface, however, without extensive pulp coagulation. It is concluded that the effects of laser irradiation on the pulpal microcirculation may be studied in situ by means of the presented methodology.

Animals↗
PubMed1991

[The tooth transplant in orthodontic treatment planning].

The analysis of all examined transplant cases combined treated with orthodontics shows a success rate of 76%. It must be underlined that the germ development at the time of the transplantation is of utmost importance. The best possible time proved to be at a root development of 2/3 to 3/4. Exact indication position, a careful atraumatic operation method and a short time of operation are also important factors of a successful transplantation. If all these preconditions are met, this method can be recommended.

Adolescent↗
PubMed1987

A comparison of monopolar and bipolar electrical stimuli and thermal stimuli in determining the vitality of autotransplanted human teeth.

Of 33 autotransplanted maxillary canines, 13 responded to cathodal monopolar stimuli, 15 to bipolar stimuli and nine to a cold stimulus. Responses returned between seven weeks and 26 months after transplantation and indicated that the coronal pulp was reinnervated. There was no evidence that comparison of monopolar and bipolar stimulation might distinguish between the vitality of the coronal and radicular pulp, probably because monopolar stimuli did not excite nerves within the root. The thresholds to both forms of electrical stimulation were raised; the bipolar threshold was significantly higher than the monopolar. No transplanted teeth which responded to a cold stimulus did not also respond to an electrical stimulus.

Adolescent↗
PubMed1986

Pulp innervation after radiation therapy.

Decreased sensitivity was observed in teeth within and adjacent to an irradiated field. Mandibular teeth outside the field and distal to the irradiated mandibular nerve trunk showed an immediate decrease in sensitivity, Maxillary teeth outside the field showed a delayed decrease in sensitivity. Blood flow rates and nutrition were also related to time. Neurons are though to be relatively radio-resistant and few changes were seen histologically after radiation therapy. However, functional impairment was observed in histologically normal tissue.

Dental Pulp↗
PubMed1992

Pulpal evaluation of teeth restored with fixed prostheses.

The literature demonstrates that each of the elements of crown fabrication involves possible and probable insult to the pulpal tissues of the tooth. Preparation of the tooth can result in pulpal inflammation or even burn lesions. The impression technique can result in reduction of the odontoblastic layer caused by drying of the dentin. Temporary coverage of the preparation involves the use of self-curing resins and temporary cements, both of which can irritate the pulp. The final restoration is attached with cements that are often implicated in pulpal irritation. Dental caries and the procedures necessary to remove it and restore the tooth before preparation for a fixed prosthesis can injure the pulp. This study was done to evaluate the effects of complete coverage fixed prosthetic restorations on the dental pulp. A recall letter was mailed to 1221 patients who had received a fixed partial denture or single crown during the years 1984-1988. One hundred thirty patients were examined. Each tooth was evaluated for pulpal health, periodontal integrity, and clinical acceptability of the restoration. Of the 603 teeth examined, 166 had undergone root canal therapy before placement of the restoration, leaving 437 that were crowned while vital. Of these, 25 (5.7%) were in need of root canal therapy or had undergone root canal therapy after cementation of the fixed prosthesis.

Crowns↗