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Comparative Evaluation of Factors Minimizing the Amount of Needle Deflection During Inferior Alveolar Nerve Block – An In Vitro Study

Year 2013, Volume: 6 Issue: 2, 74 - 83, 01.06.2013

Asok Mathew Aysha Rashed Ali Al Ansari Ahmed Ali Radaideh Nisha T Varughese

Abstract

Failure of local anaesthesia is a common problem faced in the clinical practice. Inferior alveolar nerve block is showing high percentage of failure among the local anaesthesia techniques. The study is conducted to understand the factors minimising the amount of needle deflection during the inferior alveolar nerve block. Successful local anaesthesia has been critical to the daily practice of dentistry. It is required to ensure maximum patient comfort while clinical procedures are being performed. The main objective of the study is to assess various factors affecting the deflection of the needle while giving inferior alveolar nerve block anaesthesia in a tissue like material agar-agar having almost similar physical properties to human tissues. This study was conducted to investigate the cause-and-effect relationship between many factors (needle gauge, tip design, angle of insertion, insertion technique and thickness of tissue) and amount of needle deflection during inferior alveolar nerve block. The study was conducted with fourteen in vitro deflection test models ( 2.5x2x2 cm ) using tissue like substance ( reversible hydrocolloid ) mounted on a dental surveyor for standardized needle insertions to standardized depth of 25 mm and radiographic analysis was performed after each insertion by measuring the vertical deflection in millimetres (to the nearest 1/10th mm). We used the one-way ANOVA procedure with multiple comparisons. The present study indicates that tip of needle design, technique of insertion and thickness of tissue can significantly affect the deflection of the needle while factor like angle of insertion of the needle has the least effect on amount of deflection. The present report indicates that thickness of the tissue and gauge of needle has significant effect on the amount of needle deflection. At the same time, bi-bevelled needle tip and rotational insertion technique provide minimum amount of deflection. Angle of insertion has the least effect on amount of deflection. Experimental article (J Int Dent Med Res 2013; 6: (2), pp. 74-83)

Keywords

Inferior alveolar nerve block [IANB] Deflection and Reversible hydrocolloid.

References

  • Rood JP, Weinstein P,Etidocaine in dentistry, Anesth prog 1989: 36: 171-192.
  • Jastak JT, Yagiela JA, Local Anesthesia of the oral cavity, Philadelphia, Saunders, 1995; Edn 2 133.
  • Barker BC, Davies PL, The applied anatomy of the petrygomandibular space, Br J Oral Surgery 1972; 10:43-45.
  • Roda RS, Banton PL. The anatomy of local anesthesia. Quintessence Int 1994;25:27-38.
  • John G Mechaan, Practical dental local anesthesia, Quintessence publishing Co Ltd UK 2010;:5-6.
  • A Kingon,* P Sambrook,_ A Goss_ Higher concentration local anaesthetics causing prolonged anaesthesia. Do they? A literature review and case reports , Australian Dental Journal 2011; 56: 348 –3
  • Arthur H. Jeske, , Mis -conceptions involving dental anesthesia Texas Dental Journal,2002 ; 4: 296-307.
  • Adam Ramford , Bristol Dental Hospital , SAAD DIGEST , volume 23 , JAN 2007 ; 24-25.
  • Pushpendra Kumar Verma Anesthetic efficacy of X-tip intraosseous injection using 2% lidocaine with 1:80,000 epinephrine in patients with irreversible pulpitis after inferior alveolar nerve block: A clinical studyJournal of Conservative Dentistry | Mar-Apr 2013; 16( 2):163-165
  • Nigel D Robb , Sedation in Relation to Dentistry, SAAD DIGEST 2011;2: (27) : 53.
  • Lehtinen R: Penetration of 27- and 30-gauge dental needles. Int J Oral Surg 1983;12: (6)444-445.
  • Amereican academy of pediatric dentistry(2009) guidelines in the use of local anaesthesia for paediatric dental; patients. Reference manual, 2009 ; 34 (6) ;1 2 / 1 3; 184-7.
  • Marcello Augello et al. Needle breakage during local anesthesia in the oral cavity —a retrospective of the last 50 years with guidelines for treatment and prevention. Clin Oral Invest 2011; 15:3 –8
  • Okamoto Y, Takasugi Y, Moriya K, Furuya H,Inferior alveolar nerve block by injection into the pterygomandibularspace anterior to the mandibular foramen: radiographic study of local anesthetic spread in the pterygomandibular space. Anesth Prog 2000; 47(4):130 –133
  • Aldous JA: Needle deflection: A factor in the administration of local anesthetics. J Am Dent Assoc 1968 ;77:(3); 602-604.
  • Koichi Yoshimura, Development of a tissue-equivalent MRI phantom using carrageenan gel Magn Reson Med 2003; 50:(5)1011 –10
  • Robinson SF, Mayhew RB, Crown RD, Hawley RJ, comparative study of deflection characteristitics and fragility of 25-27 and 30 gauge short needle anesthesia, J Am Dent Assoc 1984;(2)109:9209
  • Smith N. An investigation of the influence of gauge on some physical properties of hypodermic needle -Relation between gauge and flexibility of the needle .Aust Dent J 1968; 13 : (2)158-163.
  • Jeske AH, Boshart BF, Deflection of conventional versus nondeflecting dental needle in vitro, Anesth Prog 1985; 32(1): :62-64.
  • Mark N , Hochman In vitro study of needle deflection- A linear insertion versus bidirectional rotational insertion technique , Quintessence International , 2000 ;(1) 31 :33-39.
  • Berns JM , Sadove MS .Mandibular block injection , A method of study using an injected radioopaque material ,J Am Dent Assoc 1962 ;(1) 65:735-45.
  • Stanley F. Malamed, DDS, Handbook of local anesthesia, Ed.2004;.230-32 Variable* amount of variation 1 5 100 0.245 0.548 0.500 000 2 5 0.700 0.122 0.274 0.500 000 3 5 600 0.245 0.548 000 000 4 5 100 0.245 0.548 0.500 000
  • Table Results of sample A. Table Results of sample B. Table Results of sample C. Variable* amount of variation Try Count Mean SE mean St Dev Min Max 1 5 100 0.245 0.548 0.500 000 2 5 600 0.245 0.548 000 000 3 5 400 0.678 517 000 000 Table Results of sample D. 1 5 800 0.490 095 000 000 2 5 000 0.316 0.707 000 000 3 5 800 0.374 0.837 000 000 4 5 800 0.490 095 000 000 Variable* amount of variation 1 5 100 0.245 0.548 0.500 000 2 5 0.700 0.122 0.274 0.500 000 3 5 400 0.245 0.548 000 000

Comparative Evaluation of Factors Minimizing the Amount of Needle Deflection During Inferior Alveolar Nerve Block – An In Vitro Study

Year 2013, Volume: 6 Issue: 2, 74 - 83, 01.06.2013

Asok Mathew Aysha Rashed Ali Al Ansari Ahmed Ali Radaideh Nisha T Varughese

Abstract

Keywords

-

References

  • Rood JP, Weinstein P,Etidocaine in dentistry, Anesth prog 1989: 36: 171-192.
  • Jastak JT, Yagiela JA, Local Anesthesia of the oral cavity, Philadelphia, Saunders, 1995; Edn 2 133.
  • Barker BC, Davies PL, The applied anatomy of the petrygomandibular space, Br J Oral Surgery 1972; 10:43-45.
  • Roda RS, Banton PL. The anatomy of local anesthesia. Quintessence Int 1994;25:27-38.
  • John G Mechaan, Practical dental local anesthesia, Quintessence publishing Co Ltd UK 2010;:5-6.
  • A Kingon,* P Sambrook,_ A Goss_ Higher concentration local anaesthetics causing prolonged anaesthesia. Do they? A literature review and case reports , Australian Dental Journal 2011; 56: 348 –3
  • Arthur H. Jeske, , Mis -conceptions involving dental anesthesia Texas Dental Journal,2002 ; 4: 296-307.
  • Adam Ramford , Bristol Dental Hospital , SAAD DIGEST , volume 23 , JAN 2007 ; 24-25.
  • Pushpendra Kumar Verma Anesthetic efficacy of X-tip intraosseous injection using 2% lidocaine with 1:80,000 epinephrine in patients with irreversible pulpitis after inferior alveolar nerve block: A clinical studyJournal of Conservative Dentistry | Mar-Apr 2013; 16( 2):163-165
  • Nigel D Robb , Sedation in Relation to Dentistry, SAAD DIGEST 2011;2: (27) : 53.
  • Lehtinen R: Penetration of 27- and 30-gauge dental needles. Int J Oral Surg 1983;12: (6)444-445.
  • Amereican academy of pediatric dentistry(2009) guidelines in the use of local anaesthesia for paediatric dental; patients. Reference manual, 2009 ; 34 (6) ;1 2 / 1 3; 184-7.
  • Marcello Augello et al. Needle breakage during local anesthesia in the oral cavity —a retrospective of the last 50 years with guidelines for treatment and prevention. Clin Oral Invest 2011; 15:3 –8
  • Okamoto Y, Takasugi Y, Moriya K, Furuya H,Inferior alveolar nerve block by injection into the pterygomandibularspace anterior to the mandibular foramen: radiographic study of local anesthetic spread in the pterygomandibular space. Anesth Prog 2000; 47(4):130 –133
  • Aldous JA: Needle deflection: A factor in the administration of local anesthetics. J Am Dent Assoc 1968 ;77:(3); 602-604.
  • Koichi Yoshimura, Development of a tissue-equivalent MRI phantom using carrageenan gel Magn Reson Med 2003; 50:(5)1011 –10
  • Robinson SF, Mayhew RB, Crown RD, Hawley RJ, comparative study of deflection characteristitics and fragility of 25-27 and 30 gauge short needle anesthesia, J Am Dent Assoc 1984;(2)109:9209
  • Smith N. An investigation of the influence of gauge on some physical properties of hypodermic needle -Relation between gauge and flexibility of the needle .Aust Dent J 1968; 13 : (2)158-163.
  • Jeske AH, Boshart BF, Deflection of conventional versus nondeflecting dental needle in vitro, Anesth Prog 1985; 32(1): :62-64.
  • Mark N , Hochman In vitro study of needle deflection- A linear insertion versus bidirectional rotational insertion technique , Quintessence International , 2000 ;(1) 31 :33-39.
  • Berns JM , Sadove MS .Mandibular block injection , A method of study using an injected radioopaque material ,J Am Dent Assoc 1962 ;(1) 65:735-45.
  • Stanley F. Malamed, DDS, Handbook of local anesthesia, Ed.2004;.230-32 Variable* amount of variation 1 5 100 0.245 0.548 0.500 000 2 5 0.700 0.122 0.274 0.500 000 3 5 600 0.245 0.548 000 000 4 5 100 0.245 0.548 0.500 000
  • Table Results of sample A. Table Results of sample B. Table Results of sample C. Variable* amount of variation Try Count Mean SE mean St Dev Min Max 1 5 100 0.245 0.548 0.500 000 2 5 600 0.245 0.548 000 000 3 5 400 0.678 517 000 000 Table Results of sample D. 1 5 800 0.490 095 000 000 2 5 000 0.316 0.707 000 000 3 5 800 0.374 0.837 000 000 4 5 800 0.490 095 000 000 Variable* amount of variation 1 5 100 0.245 0.548 0.500 000 2 5 0.700 0.122 0.274 0.500 000 3 5 400 0.245 0.548 000 000
There are 23 citations in total.

Details

Primary Language Turkish
Journal Section Articles
Authors

Asok Mathew This is me

Aysha Rashed Ali Al Ansari This is me

Ahmed Ali Radaideh This is me

Nisha T Varughese This is me

Publication Date June 1, 2013
Published in Issue Year 2013 Volume: 6 Issue: 2

Cite

APA Mathew, A., Ansari, A. R. A. A., Radaideh, A. A., Varughese, N. T. (2013). Comparative Evaluation of Factors Minimizing the Amount of Needle Deflection During Inferior Alveolar Nerve Block – An In Vitro Study. Journal Of International Dental And Medical Research, 6(2), 74-83.
AMA Mathew A, Ansari ARAA, Radaideh AA, Varughese NT. Comparative Evaluation of Factors Minimizing the Amount of Needle Deflection During Inferior Alveolar Nerve Block – An In Vitro Study. JIDMR. June 2013;6(2):74-83.
Chicago Mathew, Asok, Aysha Rashed Ali Al Ansari, Ahmed Ali Radaideh, and Nisha T Varughese. “Comparative Evaluation of Factors Minimizing the Amount of Needle Deflection During Inferior Alveolar Nerve Block – An In Vitro Study”. Journal Of International Dental And Medical Research 6, no. 2 (June 2013): 74-83.
EndNote Mathew A, Ansari ARAA, Radaideh AA, Varughese NT (June 1, 2013) Comparative Evaluation of Factors Minimizing the Amount of Needle Deflection During Inferior Alveolar Nerve Block – An In Vitro Study. Journal Of International Dental And Medical Research 6 2 74–83.
IEEE A. Mathew, A. R. A. A. Ansari, A. A. Radaideh, and N. T. Varughese, “Comparative Evaluation of Factors Minimizing the Amount of Needle Deflection During Inferior Alveolar Nerve Block – An In Vitro Study”, JIDMR, vol. 6, no. 2, pp. 74–83, 2013.
ISNAD Mathew, Asok et al. “Comparative Evaluation of Factors Minimizing the Amount of Needle Deflection During Inferior Alveolar Nerve Block – An In Vitro Study”. Journal Of International Dental And Medical Research 6/2 (June 2013), 74-83.
JAMA Mathew A, Ansari ARAA, Radaideh AA, Varughese NT. Comparative Evaluation of Factors Minimizing the Amount of Needle Deflection During Inferior Alveolar Nerve Block – An In Vitro Study. JIDMR. 2013;6:74–83.
MLA Mathew, Asok et al. “Comparative Evaluation of Factors Minimizing the Amount of Needle Deflection During Inferior Alveolar Nerve Block – An In Vitro Study”. Journal Of International Dental And Medical Research, vol. 6, no. 2, 2013, pp. 74-83.
Vancouver Mathew A, Ansari ARAA, Radaideh AA, Varughese NT. Comparative Evaluation of Factors Minimizing the Amount of Needle Deflection During Inferior Alveolar Nerve Block – An In Vitro Study. JIDMR. 2013;6(2):74-83.