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Revista ADM Órgano Oficial de la Asociación Dental Mexicana

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Órgano Oficial de la Asociación Dental Mexicana
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2013, Number 2

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Rev ADM 2013; 70 (2)

In vitro study of 27 and 30-gauge needle deflection using three different insertion techniques

Leyva LVG, Luna LCA, Quesada CJA, Téllez JH, Oliver PR
Full text How to cite this article

Language: Spanish
References: 8
Page: 76-80
PDF size: 229.51 Kb.


Key words:

Needle deflection, anesthetic failure, hydrocolloid, parallelometer, insertion technique.

ABSTRACT

Introduction: Needle deflection during insertion can, in itself, be a cause of anesthetic failure. Objective: To determine the degree of deflection of 27-gauge and 30-gauge needles using three insertion techniques on a simulated tissue model. Materials and methods: Controlled, experimental in vitro study in which, with the aid of a parallelometer, controlled insertions in hydrocolloids were performed to a depth of 20 mm using 27-gauge and 30-gauge needles (n = 15). Three different insertion techniques were assessed: the direct insertion technique (DIT), the bidirectional rotation insertion technique (BRIT), and a technique proposed in this study, called modified rotational insertion technique (MRIT). The deflection suffered by the needle and its direction were observed under stereomicroscopy. Results: The modified rotational insertion technique was significantly more effective, presenting the lowest needle deflection (p = 0.000). The direction of deflection was directly related to the position of the beveled face of the needle. Conclusions: The vector forces exerted by simulated tissue on the beveled face of the needle during insertion are responsible for the deflection. Using the modified rotational insertion technique, a balance between these forces is achieved when inserting 27-gauge and 30-gauge needles in hydrocolloids.


REFERENCES

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  2. Kennedy S, Reader A, Nusstein J, Beck M. The significance of needle deflection in success of the inferior alveolar nerve block in patients whit irreversible pulpitis. J Endod 2003; 29 (10): 630-3.

  3. Gautam A, Sonal G, Arjun D. Failure of inferior alveolar nerve block. J Am Dent Assoc 2002; 133: 843-6.

  4. Meechan JG. How to overcome failed anesthesia. Br Dent J 1999; 186 (1): 15-20.

  5. Malamed SF. Manual de anestesia local. 5ª ed. Madrid, España: Ed. Elsevier; 2006.

  6. Robinson SF, Mayhew RB, Cowan RD, Hawley RJ. Comparative study of deflection characteristics and fragility of 25, 27 and 30 gauge short dental needles. J Am Dent Assoc 1984; 109: 920-4.

  7. Aldous JA. Needle deflection: a factor in the administration of local anesthetics. J Am Dent Assoc 1968; 77 (3): 602-4.

  8. Hochman MN, Friedman MJ. In vitro study of needle deflection: a linear insertion technique versus a bidirectional rotation insertion technique. Quint Int 2000; 31: 737-43.




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Rev ADM. 2013;70