Abstract
To determine whether a repeated intraosseous (IO) injection would increase or prolong pulpal anesthesia, we measured the degree of anesthesia obtained by a repeated IO injection given 30 min following a combination inferior alveolar nerve block/intraosseous injection (IAN/IO) in mandibular second premolars and in first and second molars. Using a repeated-measures design, we randomly assigned 38 subjects to receive two combinations of injections at two separate appointments. The combinations were an IAN/IO injection followed approximately 30 min later by another IO injection of 0.9 ml of 2% lidocaine with 1:100,000 epinephrine and a combination IAN/IO injection followed approximately 30 min later by a mock IO injection. The second premolar, first molar, and second molar were blindly tested with an Analytic Technology pulp tester at 2-min cycles for 120 min postinjection. Anesthesia was considered successful when two consecutive readings of 80 were obtained. One hundred percent of the subjects had lip numbness with IAN/IO and with IAN/IO plus repeated IO techniques. Rates of anesthetic success for the IAN/IO and for the IAN/IO plus repeated IO injection, respectively, were 100% and 97% for the second premolar, 95% and 95% for the first molar, and 87% and 87% for the second molar. The repeated IO injection increased pulpal anesthesia for approximately 14 min in the second premolar and for 6 min in the first molar, but no statistically significant differences (P > 0.05) were shown. In conclusion, the repeated IO injection of 0.9 ml of 2% lidocaine with 1:100,000 epinephrine given 30 min following a combination IAN/IO injection did not significantly increase pulpal anesthesia in mandibular second premolars or in first and second molars.
Full text
PDF
Selected References
These references are in PubMed. This may not be the complete list of references from this article.
- Certosimo A. J., Archer R. D. A clinical evaluation of the electric pulp tester as an indicator of local anesthesia. Oper Dent. 1996 Jan-Feb;21(1):25–30. [PubMed] [Google Scholar]
- Coggins R., Reader A., Nist R., Beck M., Meyers W. J. Anesthetic efficacy of the intraosseous injection in maxillary and mandibular teeth. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 1996 Jun;81(6):634–641. doi: 10.1016/s1079-2104(96)80067-9. [DOI] [PubMed] [Google Scholar]
- Dreven L. J., Reader A., Beck M., Meyers W. J., Weaver J. An evaluation of an electric pulp tester as a measure of analgesia in human vital teeth. J Endod. 1987 May;13(5):233–238. doi: 10.1016/s0099-2399(87)80097-3. [DOI] [PubMed] [Google Scholar]
- Dunbar D., Reader A., Nist R., Beck M., Meyers W. J. Anesthetic efficacy of the intraosseous injection after an inferior alveolar nerve block. J Endod. 1996 Sep;22(9):481–486. doi: 10.1016/S0099-2399(96)80083-5. [DOI] [PubMed] [Google Scholar]
- Leonard M. S. The efficacy of an intraosseous injection system of delivering local anesthetic. J Am Dent Assoc. 1995 Jan;126(1):81–86. doi: 10.14219/jada.archive.1995.0027. [DOI] [PubMed] [Google Scholar]
- McLean C., Reader A., Beck M., Meryers W. J. An evaluation of 4% prilocaine and 3% mepivacaine compared with 2% lidocaine (1:100,000 epinephrine) for inferior alveolar nerve block. J Endod. 1993 Mar;19(3):146–150. doi: 10.1016/s0099-2399(06)80510-8. [DOI] [PubMed] [Google Scholar]
- Nusstein J., Reader A., Nist R., Beck M., Meyers W. J. Anesthetic efficacy of the supplemental intraosseous injection of 2% lidocaine with 1:100,000 epinephrine in irreversible pulpitis. J Endod. 1998 Jul;24(7):487–491. doi: 10.1016/S0099-2399(98)80053-8. [DOI] [PubMed] [Google Scholar]
- Reisman D., Reader A., Nist R., Beck M., Weaver J. Anesthetic efficacy of the supplemental intraosseous injection of 3% mepivacaine in irreversible pulpitis. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 1997 Dec;84(6):676–682. doi: 10.1016/s1079-2104(97)90372-3. [DOI] [PubMed] [Google Scholar]
- Reitz J., Reader A., Nist R., Beck M., Meyers W. J. Anesthetic efficacy of the intraosseous injection of 0.9 mL of 2% lidocaine (1:100,000 epinephrine) to augment an inferior alveolar nerve block. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 1998 Nov;86(5):516–523. doi: 10.1016/s1079-2104(98)90339-0. [DOI] [PubMed] [Google Scholar]
- Replogle K., Reader A., Nist R., Beck M., Weaver J., Meyers W. J. Anesthetic efficacy of the intraosseous injection of 2% lidocaine (1:100,000 epinephrine) and 3% mepivacaine in mandibular first molars. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 1997 Jan;83(1):30–37. doi: 10.1016/s1079-2104(97)90087-1. [DOI] [PubMed] [Google Scholar]