Martínez MA, Lujan PMP, Portillo HD

Language: Spanish
References: 10
Page: 34-39
PDF size: 255.10 Kb.

ABSTRACT

Objectives: The authors conducted a clinical-trial, uncontrolled study to determine infraorbital nerve block effectiveness. Material and methods: Nineteen adult volunteers received 1.8 mL of lidocaine 2% with epinephrine 1:80,000 with an intraoral, infraorbital nerve block. Researchers used an electric pulp tester to measure pulp anesthesia in maxillary incisors and premolars. Participants reported soft tissue anesthesia and discomfort during the injection procedure; anesthesia onset time and its duration were also assessed and analyzed. Authors analyzed data using STATA statistical program 9^®. Results: Most of the subjects in our trial were 21 years old (30%); the number of female participants (n = 12 - 60%) was greater than that of male participants. Authors evaluated pain perception when injecting anesthesia with a visual analogue scale (VAS), finding that 57.9% of patients (n = 11) categorized the pain as moderate (in a scale of 3-6). When assessing anesthesia success, it was observed that a greater number of canine teeth and first premolars (57.9%, n = 9 - CI 95%) were anesthetized. The authors also observed a significant greater number of non-response (non-anesthetized) cases in central and lateral incisors (100-84.2%, respectively). Anesthesia onset was at 12 to 19 minutes, with canines exhibiting the largest number of anesthetized reports with 47.4%. There was a 100% incidence of subjective feeling of soft tissue anesthesia in lower eyelid skin, skin of the nose and skin of the upper lip. Authors noted that 100% of the subjects rated it as unpleasant (VAS). Conclusions: Infraorbital anesthesia technique achieved successful anesthesia in only 57.9% of upper canines and first premolars; it proved ineffective for anesthetizing central and lateral incisors. This was demonstrated after these teeth were evaluated using rigorous pulp vitality testing. Soft tissue anesthesia occurred and it was classified as uncomfortable. Authors consider that usefulness of infraorbital nerve block technique in dentistry was questionable.

REFERENCES

1. Malamed SF. Handbook of local anesthesia. 5th ed. St Louis: The CV Mosby Co; 2004.

2. Martínez-Martínez AA. Anestesia de maxilar superior. En: Martínez-Martínez A. Anestesia bucal guía práctica. Colombia: Ed. Panamericana; 2009. pp. 65-74.

3. Reed KL, Malamed SF, Fonner M. Local anesthesia part 2: technical considerations. Anesth Prog. 2012; 59: 127-137.

4. Gaudy JF, Arreto CD. Manual de anestesia en odontoestomatología. España: Ed. Elsevier; 2006.

5. Heasman PA. Clinical anatomy of the superior alveolar nerves. Br J Oral Max Surg. 1984; 22: 439-447.

6. Berberich G, Reader A, Drum M, Nusstein J, Beck M. A prospective, randomized, double-blind comparison of the anesthetic efficacy of two percent lidocaine with 1:100,000 and 1:50,000 epinephrine and three percent mepivacaine in the intraoral, infraorbital nerve block. J Endod. 2009; 35 (11): 1498-1504. doi: 10.1016/j.joen.2009.08.007. Epub 2009 Sep 20.

7. Karkut B, Reader A, Drum M, Nusstein J, Beck M. A comparison of the local anesthetic efficacy of the extraoral versus the intraoral infraorbital nerve block. J Am Dent Assoc. 2010; 141 (2): 185-192.

8. Mason R, Drum M, Reader A, Nusstein J, Beck M. A prospective, randomized, double-blind comparison of 2% lidocaine with 1:100,000 and 1:50,000 epinephrine and 3% mepivacaine for maxillary infiltrations. J Endod. 2009; 35: 1173-1177.

9. Katz S, Drum M, Reader A, Nusstein J, Beck MA. Prospective, randomized, double-blind comparison of 2% lidocaine with 1:100,000 epinephrine, 4% prilocaine with 1:200,000 epinephrine, and 4% prilocaine for maxillary infiltrations. Anesth Prog. 2010; 57: 45-51.

10. Corbett IP, Jaber AA, Whitworth JM, Meechan JG. A comparison of the anterior middle superior alveolar nerve block and infraorbital nerve block for anesthesia of maxillary anterior teeth. J Am Dent Assoc. 2010; 141 (12): 1442-1448.