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Efficacy and complications associated with a modified inferior alveolar nerve block technique. A randomized, triple-blind clinical trial.

Montserrat-Bosch M, Figueiredo R, Nogueira-Magalhães P, Arnabat-Dominguez J, Valmaseda-Castellón E, Gay-Escoda C - Med Oral Patol Oral Cir Bucal (2014)

Bottom Line: The modified technique group showed a significantly higher onset time in the lower lip and chin area, and was frequently associated to a lingual electric discharge sensation.Three failures were recorded, 2 of them in the experimental group.No relevant local or systemic complications were registered.

View Article: PubMed Central - PubMed

Affiliation: Faculty of Dentistry - University of Barcelona, Campus de Bellvitge, Facultat d`Odontologia, Cirugía e Implantología Bucal, C/ Feixa Llarga, s/n; Pavelló Govern, 2 planta, Despatx 2.9, 08907 L'Hospitalet de Llobregat, Barcelona, Spain, rui@ruibf.com.

ABSTRACT

Objective: To compare the efficacy and complication rates of two different techniques for inferior alveolar nerve blocks (IANB).

Study design: A randomized, triple-blind clinical trial comprising 109 patients who required lower third molar removal was performed. In the control group, all patients received an IANB using the conventional Halsted technique, whereas in the experimental group, a modified technique using a more inferior injection point was performed.

Results: A total of 100 patients were randomized. The modified technique group showed a significantly higher onset time in the lower lip and chin area, and was frequently associated to a lingual electric discharge sensation. Three failures were recorded, 2 of them in the experimental group. No relevant local or systemic complications were registered.

Conclusions: Both IANB techniques used in this trial are suitable for lower third molar removal. However, performing an inferior alveolar nerve block in a more inferior position (modified technique) extends the onset time, does not seem to reduce the risk of intravascular injections and might increase the risk of lingual nerve injuries.

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Related in: MedlinePlus

Flow diagram with the patients included in each stage of the trial.
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Figure 3: Flow diagram with the patients included in each stage of the trial.

Mentions: A total of 100 patients with a mean age of 28.2 years (SD=8.4) were randomized (Fig. 3). Two patients in the experimental group and 1 patient in the control group did not refer a numbness area in the lower lip and chin region after 5 minutes. These patients received a second IANB and were considered as failures. Therefore, in these patients some variables were not gathered. The baseline and clinical characteristics for each group are shown in Table 1. The variables related with complications and efficacy can be observed in Table 2. Patients in the experimental group showed a significantly higher onset time in the lower lip and chin area (median time of 82.5 seconds vs. 45 seconds in the control group). An electrical discharge sensation in the tongue during injection was also significantly more frequent when the modified technique was used. However, no postoperative paresthesias were recorded. Additional injections (infiltrative, intraligamentous and intrapulpar) to obtain a more adequate pain control were less frequent in the control group (36.7% Vs. 47.9%; p>0.05).


Efficacy and complications associated with a modified inferior alveolar nerve block technique. A randomized, triple-blind clinical trial.

Montserrat-Bosch M, Figueiredo R, Nogueira-Magalhães P, Arnabat-Dominguez J, Valmaseda-Castellón E, Gay-Escoda C - Med Oral Patol Oral Cir Bucal (2014)

Flow diagram with the patients included in each stage of the trial.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4119316&req=5

Figure 3: Flow diagram with the patients included in each stage of the trial.
Mentions: A total of 100 patients with a mean age of 28.2 years (SD=8.4) were randomized (Fig. 3). Two patients in the experimental group and 1 patient in the control group did not refer a numbness area in the lower lip and chin region after 5 minutes. These patients received a second IANB and were considered as failures. Therefore, in these patients some variables were not gathered. The baseline and clinical characteristics for each group are shown in Table 1. The variables related with complications and efficacy can be observed in Table 2. Patients in the experimental group showed a significantly higher onset time in the lower lip and chin area (median time of 82.5 seconds vs. 45 seconds in the control group). An electrical discharge sensation in the tongue during injection was also significantly more frequent when the modified technique was used. However, no postoperative paresthesias were recorded. Additional injections (infiltrative, intraligamentous and intrapulpar) to obtain a more adequate pain control were less frequent in the control group (36.7% Vs. 47.9%; p>0.05).

Bottom Line: The modified technique group showed a significantly higher onset time in the lower lip and chin area, and was frequently associated to a lingual electric discharge sensation.Three failures were recorded, 2 of them in the experimental group.No relevant local or systemic complications were registered.

View Article: PubMed Central - PubMed

Affiliation: Faculty of Dentistry - University of Barcelona, Campus de Bellvitge, Facultat d`Odontologia, Cirugía e Implantología Bucal, C/ Feixa Llarga, s/n; Pavelló Govern, 2 planta, Despatx 2.9, 08907 L'Hospitalet de Llobregat, Barcelona, Spain, rui@ruibf.com.

ABSTRACT

Objective: To compare the efficacy and complication rates of two different techniques for inferior alveolar nerve blocks (IANB).

Study design: A randomized, triple-blind clinical trial comprising 109 patients who required lower third molar removal was performed. In the control group, all patients received an IANB using the conventional Halsted technique, whereas in the experimental group, a modified technique using a more inferior injection point was performed.

Results: A total of 100 patients were randomized. The modified technique group showed a significantly higher onset time in the lower lip and chin area, and was frequently associated to a lingual electric discharge sensation. Three failures were recorded, 2 of them in the experimental group. No relevant local or systemic complications were registered.

Conclusions: Both IANB techniques used in this trial are suitable for lower third molar removal. However, performing an inferior alveolar nerve block in a more inferior position (modified technique) extends the onset time, does not seem to reduce the risk of intravascular injections and might increase the risk of lingual nerve injuries.

Show MeSH
Related in: MedlinePlus