İNFLAMASYONLU DİŞLERDE ANESTEZİ YETERSİZLİĞİ VE GÜNCEL ÇÖZÜM ÖNERİLERİ

Yıl 2021, Cilt: 31 Sayı: 3, 481 - 490, 14.07.2021

Seda Elmas Mesut Enes Odabaş

https://doi.org/10.17567/ataunidfd.782482

Öz

Geri dönüşümsüz pulpitisli hastalarda başarılı lokal anestezi elde etmek, diş hekimleri için büyük bir sorun oluşturmaktadır. İnflamatuar lezyonları olan, pulpitis ve apikal periodontitisli dişlerde anestezi etkinliği oldukça azalmaktadır. Bu dişlerde anestezi başarısızlığı ile ilgili; iyon tuzağı mekanizması (inflamatuar asidoz mekanizması), peroksinitritlerin etkisi, inflamasyonun periferal vasküler sistem üzerindeki etkisi, nosiseptörlerin membran uyarılabilirliğinin değişimi, tetradoksine (TTX) dirençli sodyum (Na) kanalları ve santral sensitizasyon teorisi gibi birçok neden öne sürülmüştür. Bu derlemede geri dönüşümsüz pulpitisli dişlerde anestezi başarısızlığı için önerilen teoriler ve başarısızlığa karşı uygulanabilecek güncel yaklaşımlar literatür bilgileri ışığında tartışılmıştır.
Anahtar kelimeler: Anestezi başarısızlığı, geri dönüşümsüz pulpitis, inflamasyon, lokal anestezi

Anesthesia Failure in Inflamed Teeth and Current Solution Recommendations
Abstract
Successful local anesthesia in irreversible pulpitis is a major problem for dentists. The effects of anesthesia on the teeth with inflammatory lesions, pulpitis and apical periodontitis are considerably reduced. Several reasons have been proposed for the failure of anesthesia in these teeth, such as the mechanism of ion trap (mechanism of inflammatory acidosis), the effect of peroxynitrite, the effect of inflammation on the peripheral vascular system, the change of membrane excitability of nociceptors, tetradoxine (TTX) resistant sodium (Na) channels and central sensitization theory. In this review, the theories proposed for failure of anesthesia in irreversible pulpitis and current approaches to failure are discussed in the light of the literature.
Keywords: Anesthesia failure, inflammation, irreversible pulpitis, local anesthesia

Anahtar Kelimeler

Anestezi başarısızlığı, geri dönüşümsüz pulpitis, inflamasyon

Kaynakça

• 1. Tsuchiya H. Dental Anesthesia in the Presence of Inflammation: Pharmacological Mechanisms for the Reduced Efficacy of Local Anesthetics. Int J Clin Anesth 2016; 4: 1059-75.
• 2. Moradi Askari E, Parirokh M, Nakhaee N, Hosseini HR and Abbott PV. The Effect of Maxillary First Molar Root Length on the Success Rate of Buccal Infiltration Anesthesia. J Endod 2016; 42: 1462-6.
• 3. Kanaa MD, Whitworth JM and Meechan JG. A comparison of the efficacy of 4% articaine with 1:100,000 epinephrine and 2% lidocaine with 1:80,000 epinephrine in achieving pulpal anesthesia in maxillary teeth with irreversible pulpitis. J Endod 2012; 38: 279-82.
• 4. Hosseini HR, Parirokh M, Nakhaee N, Abbott PV and Samani S. Efficacy of Articaine and Lidocaine for Buccal Infiltration of First Maxillary Molars with Symptomatic Irreversible Pulpitis: A Randomized Double-blinded Clinical Trial. Iranian Endod J 2016; 11: 79-84.
• 5. Kreimer T, Kiser R, Reader A, Nusstein J, Drum M, and Beck M. Anesthetic efficacy of combinations of 0.5 mol/L mannitol and lidocaine with epinephrine for inferior alveolar nerve blocks in patients with symptomatic irreversible pulpitis. J Endod 2012; 38: 598-603.
• 6. Fowler S, Drum M, Reader A and Beck M. Anesthetic Success of an Inferior Alveolar Nerve Block and Supplemental Articaine Buccal Infiltration for Molars and Premolars in Patients with Symptomatic Irreversible Pulpitis. J Endod 2016; 42: 390-2.
• 7. Singla M, Subbiya A, Aggarwal V et al. Comparison of the anaesthetic efficacy of different volumes of 4% articaine (1.8 and 3.6 mL) as supplemental buccal infiltration after failed inferior alveolar nerve block. Int Endod J 2015; 48: 103-8.
• 8. Aggarwal V, Singla M, Miglani S, and Kohli S. Comparison of the anaesthetic efficacy of epinephrine concentrations (1 : 80 000 and 1 : 200 000) in 2% lidocaine for inferior alveolar nerve block in patients with symptomatic irreversible pulpitis: a randomized, double-blind clinical trial. Int Endod J 2014; 47: 373-9.
• 9. Aggarwal V, Singla M, Miglani S, and Kohli S. Efficacy of Articaine Versus Lidocaine Administered as Supplementary Intraligamentary Injection after a Failed Inferior Alveolar Nerve Block: A Rando- mized Double-blind Study. J Endod 2019; 45: 1-5.
• 10. Rogers BS, Botero TM, McDonald NJ, Gardner RJ and Peters MC. Efficacy of articaine versus lidocaine as a supplemental buccal infiltration in mandibular molars with irreversible pulpitis: a prospective, randomized, double-blind study. J Endod 2014; 40: 753-8.
• 11. Parirokh M, Sadr S, Nakhaee N, Abbott PV and Askarifard S. Efficacy of supplementary buccal infiltrations and intraligamentary injections to infe- rior alveolar nerve blocks in mandibular first molars with asymptomatic irreversible pulpitis: a randomi- zed controlled trial. Int Endod J 2014; 47: 926-33.
• 12. Shahi S, Rahimi S, Yavari HR, Ghasemi N and Ahmadi F. Success Rate of 3 Injection Methods with Articaine for Mandibular First Molars with Symptomatic Irreversible Pulpitis: A CONSORT Randomized Double-blind Clinical Trial. J Endod 2018; 44: 1462-6.
• 13. Nagendrababu V, Pulikkotil SJ, Suresh A, Veettil SK, Bhatia S and Setzer FC. Efficacy of local anaesthetic solutions on the success of inferior alveolar nerve block in patients with irreversible pulpitis: a systematic review and network meta-analysis of randomized clinical trials. Int Endod J 2019; 52: 779-89.
• 14. Hargreaves KM, Keiser K. Local anesthetic failure in endodontics: Mechanisms and Management. Endod Topics 2002; 1: 26-39.
• 15. Shabin S, Shetty A, Bhat G, Hegde MN. Manage- ment of Local Anesthesia Failures in Endodontics with Different Anesthetic Techniques and Agents. Ann Res Rev Biol 2014; 4: 1080-91.
• 16. Nusstein JM, Reader A, Drum M. Local anesthesia strategies for the patient with a "hot" tooth. Dent Clin North Am 2010; 54: 237-47.
• 17. Reader A, Nusstein J. Local anesthesia for endo- dontic pain. Endod Topics 2002; 3: 14-30.
• 18. Siddiqui A, Shenoi R, Sharma HU et al. Causes Of Failure Of Dental Local Anaesthesia – A Review. Int J Contemp Med Res 2015; 2: 415-9.
• 19. Anandadeeban K.B.S. and Balakrishna R.N. Local anesthesia failure in endodontics. Drug Invention Today 2018; 10: 3866-70.
• 20. Yadav P and Kumar R. Evaluation of local anaesthetic failures in dental practice. J Int Oral Healt 2010; 2: 16-21.
• 21. Boopathi T, Sebeena M, Sivakumar K, Harikaran J, Karthick K, Raj A. Supplemental pulpal anesthesia for mandibular teeth. J Pharmacy & Bioallied Sci 2013; 5: S103-8.
• 22. Ueno T, Tsuchiya H, Mizogami M, Takakura K. Lo- cal anesthetic failure associated with inflammation: Verification of the acidosis mechanism and the hypothetic participation of inflammatory peroxyn- itrite. J Inflammation Res 2008; 1, 41-8.
• 23. Takakura K, Mizogami M, Ono Y, Ooshima K, Muramatsu I. Decrease of the inhibitory effect of lidocaine on trigeminal nerve response by the inflammatory oxidant peroxynitrite. Canadian J Anaest 2005; 52: 439-40.
• 24. Ueno T, Mizogami M, Takakura K, Tsuchiya H. Membrane effect of lidocaine is inhibited by inte- raction with peroxynitrite. J Anest 2008; 22: 96-9.
• 25. Ueno T, Mizogami M, Takakura K, Tsuchiya H. Peroxynitrite affects lidocaine by acting on memb- rane-constituting lipids. J Anest 2008; 22: 475-8.
• 26. Meechan JG. How to overcome failed local anaesthesia. Br Dent J 1999; 186: 15-20.
• 27. Meechan JG. Why does local anaesthesia not work everytime? Dental Update, 2005; 32: 66-68, 70-62.
• 28. Aggarwal V, Singla M, Rizvi A, Miglani S. Compa- rative evaluation of local infiltration of articaine, articaine plus ketorolac, and dexamethasone on anesthetic efficacy of inferior alveolar nerve block with lidocaine in patients with irreversible pulpitis. J Endod 2011; 37: 445-9.
• 29. Chavarria-Bolanos D, Rodriguez-Wong L, Noguera-Gonzalez D, Esparza-Villalpando V, Montero-Aguilar M, Pozos-Guillen A. Sensitivity, Specificity, Predic- tive Values, and Accuracy of Three Diagnostic Tests to Predict Inferior Alveolar Nerve Blockade Failure in Symptomatic Irreversible Pulpitis. Pain Research and Management, 2017; 2017(3108940).
• 30. Abbott PV and Parirokh M. Strategies for managing pain during endodontic treatment. Aust Endod J 2018; 44: 99-113.
• 31. Tüloğlu, N. ve Bayrak, Ş. Çocuk Dişhekimliğinde Kullanılan Lokal Anestezi Teknikleri ve Güncel Yaklaşımlar. Atatürk Üniv Diş Hek Fak Derg 2010; 20: 53-61.
• 32. Nusstein J, Claffey E, Reader A, Beck M, Weaver J. Anesthetic effectiveness of the supplemental int- raligamentary injection, administered with a computer- controlled local anesthetic delivery system, in patients with irreversible pulpitis. J Endod 2005; 31: 354-8.
• 33. Lin S, Wigler R, Huber R, Kaufman AY. Anaesthetic efficacy of intraligamentary injection techniques on mandibular molars diagnosed with asymptomatic irreversible pulpitis: A retrospective study. Aust Endod J 2017; 43: 34-7.
• 34. Verma PK, Srivastava R, Ramesh KM. 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 study. J of Conservative Dentistry, 2013; 16: 162-6.
• 35. Nusstein J, Kennedy S, Reader A, Beck M, Weaver J. Anesthetic efficacy of the supplemental X-tip intraosseous injection in patients with irreversible pulpitis. J Endod 2003; 29: 724-8.
• 36. Bigby J, Reader A, Nusstein J, Beck M, Weaver J. Articaine for supplemental intraosseous anesthesia in patients with irreversible pulpitis. J Endod 2006; 32: 1044-7.
• 37. Remmers T, Glickman G, Spears R, He J. The efficacy of IntraFlow intraosseous injection as a primary anesthesia technique. J Endod 2008; 34: 280-3.
• 38. Farhad A, Razavian H, Shafiee M. Effect of intraosseous injection versus inferior alveolar nerve block as primary pulpal anaesthesia of mandibular posterior teeth with symptomatic irreversible pulpitis: a prospective randomized clinical trial. Acta Odontol Scand 2018; 76: 442-7.
• 39. Kanaa MD, Whitworth JM, Meechan JG. A prospec- tive randomized trial of different supplementary lo cal anesthetic techniques after failure of inferior alveolar nerve block in patients with irreversible pulpitis in mandibular teeth. J Endod 2012; 38: 421-5.
• 40. Allegretti CE., Sampaio RM, Horliana A, Armonia PL, Rocha RG, Tortamano IP. Anesthetic Efficacy in Irreversible Pulpitis: A Randomized Clinical Trial. Brazilian Dental Journal, 2016; 27: 381-6.
• 41. Arali V and P M. Anaesthetic efficacy of 4% articaine mandibular buccal infiltration compared to 2% lignocaine inferior alveolar nerve block in children with irreversible pulpitis. J Clinand Diagnostic Research, 2015; 9: ZC65-7.
• 42. Aggarwal V, Singla M, Miglani S. Comparative Evaluation of Anesthetic Efficacy of 2% Lidocaine, 4% Articaine, and 0.5% Bupivacaine on Inferior Alveolar Nerve Block in Patients with Symptomatic Irreversible Pulpitis: A Prospective, Randomized, Double-blind Clinical Trial. J of Oral & Facial Pain and Headache, 2017; 31: 124-8.
• 43. Parirokh M and Abbott PV. Various strategies for pain-free root canal treatment. Iranian Endodontic Journal, 2014; 9: 1-14.
• 44. St George G, Morgan A, Meechan J et al. Injectable local anaesthetic agents for dental anaesthesia. Cochrane Database of Systematic Reviews, 2018; 7(CD006487).
• 45. Tempestini Horliana AC, de Brito MA, Perez FE, Simonetti MP, Rocha RG, Borsatti MA. Hyaluronidase increases the duration of mepivacaine in inferior alveolar nerve blocks. J of Oral and Maxillofacial Surgery, 2008; 66: 286-90.
• 46. Ridenour S, Reader A, Beck M, Weaver J. Anest- hetic efficacy of a combination of hyaluronidase and lidocaine with epinephrine in inferior alveolar nerve blocks. Anesth Prog 2001; 48: 9-15.
• 47. Satish SV, Shetty KP, Kilaru K, Bhargavi P, Reddy ES, Bellutgi A. Comparative evaluation of the efficacy of 2% lidocaine containing 1:200,000 epinephrine with and without hyaluronidase (75 IU) in patients with irreversible pulpitis. J Endod 2013; 39: 1116-8.
• 48. Wolf R, Reader A, Drum M, Nusstein J, Beck M. Anesthetic efficacy of combinations of 0.5 m mannitol and lidocaine with epinephrine in inferior alveolar nerve blocks: a prospective randomized, single-blind study. Anest Prog 2011; 58: 157-65.
• 49. Milani AS, Froughreyhani M, Rahimi S, Zand V, Jafarabadi MA. Volume of Anesthetic Agents and IANB Success: A Systematic Review. Anesth Prog 2018; 65: 16-23.
• 50. Abazarpoor R, Parirokh M, Nakhaee N, Abbott PV. A Comparison of Different Volumes of Articaine for Inferior Alveolar Nerve Block for Molar Teeth with Symptomatic Irreversible Pulpitis. J Endod 2015; 41: 1408-11.
• 51. Aggarwal V, Singla M, Miglani S, Kohli S, Singh S. Comparative evaluation of 1.8 mL and 3.6 mL of 2% lidocaine with 1:200,000 epinephrine for inferior alveolar nerve block in patients with irreversible pulpitis: a prospective, randomized single-blind study. J Endod 2012; 38: 753-6.
• 52. Fowler S, Reader A, Beck M. Incidence of missed inferior alveolar nerve blocks in vital asymptomatic subjects and in patients with symptomatic irreversible pulpitis. J Endod 2015; 41: 637-9.
• 53. Fowler S, and Reader A. Is a volume of 3.6 mL better than 1.8 mL for inferior alveolar nerve blocks in patients with symptomatic irreversible pulpitis? J Endod 2013; 39: 970-2. 54. Tupyota P, Chailertvanitkul P, Laopaiboon M, Ngamjarus C, Abbott PV, Krisanaprakornkit S. Supplementary techniques for pain control during root canal treatment of lower posterior teeth with irreversible pulpitis: A systematic review and meta-analysis. Aust Endod J 2018; 44: 14-25.
• 55. Parirokh M, Ashouri R, Rekabi AR, Nakhaee N, Pardakhti A, Askarifard S, Abbott PV. The effect of premedication with ibuprofen and indomethacin on the success of inferior alveolar nerve block for teeth with irreversible pulpitis. J Endod 2010; 36: 1450-4.
• 56. Modaresi J, Dianat O, Mozayeni MA. The efficacy comparison of ibuprofen, acetaminophen-codeine, and placebo premedication therapy on the depth of anesthesia during treatment of inflamed teeth. Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology, 2006; 102: 399-403.
• 57. Li C, Yang X, Ma X, Li L, Shi Z. Preoperative oral nonsteroidal anti-inflammatory drugs for the success of the inferior alveolar nerve block in irreversible pulpitis treatment: a systematic review and meta-analysis based on randomized controlled trials. Quintessence Int 2012; 43: 209-19.
• 58. Ramachandran A, Khan SI, Mohanavelu D, Kumar KS. The efficacy of pre-operative oral medication of paracetamol, ibuprofen, and aceclofenac on the success of maxillary infiltration anesthesia in patients with irreversible pulpitis: A double-blind, randomized controlled clinical trial. J Conserv Dent 2012; 15: 310-4.
• 59. de Geus JL, Wambier LM, Boing TF, Loguercio AD, Reis A. Effect of ibuprofen on the efficacy of inferior alveolar nerve block in patients with irreversible pulpitis: A meta-analysis. Aust Endod J 2018; 45: 246-58.
• 60. Jena A, and Shashirekha G. Effect of preoperative medications on the efficacy of inferior alveolar nerve block in patients with irreversible pulpitis: A placebo-controlled clinical study. J Conserv Dent 2013; 16: 171-4.
• 61. Prasanna N, Subbarao CV, Gutmann JL. The effi- cacy of pre-operative oral medication of lornoxi- cam and diclofenac potassium on the success of inferior alveolar nerve block in patients with irre- versible pulpitis: a double-blind, randomised cont- rolled clinical trial. Int Endod J 2011; 44: 330-6.
• 62. Ianiro SR, Jeansonne BG, McNeal SF, Eleazer PD. The effect of preoperative acetaminophen or a combination of acetaminophen and Ibuprofen on the success of inferior alveolar nerve block for teeth with irreversible pulpitis. J Endod 2007; 33: 11-4.
• 63. Simpson M, Drum M, Nusstein J, Reader A, Beck M. Effect of combination of preoperative ibuprofen/acetaminophen on the success of the inferior alveolar nerve block in patients with symptomatic irreversible pulpitis. J Endod 2011; 37: 593-597.
• 64. Aggarwal V, Singla M, Kabi D. Comparative eva- luation of effect of preoperative oral medication of ibuprofen and ketorolac on anesthetic efficacy of inferior alveolar nerve block with lidocaine in patients with irreversible pulpitis: a prospective, double-blind, randomized clinical trial. J Endod 2010; 36: 375-8.
• 65. Ashley PF, Parekh S, Moles DR, Anand P, MacDonald LC. Preoperative analgesics for additional pain relief in children and adolescents having dental treatment. Cochrane Database of Systematic Reviews, 2016; 8(CD008392).
• 66. Karapinar-Kazandag, M., Tanalp, J. and Ersev, H. Effect of Premedication on the Success of Inferior Alveolar Nerve Block in Patients with Irreversible Pulpitis: A Systematic Review of the Literature. BioMed Res Int 2019; 2019: 1-25.
• 67. Shahi S, Mokhtari H, Rahimi S, Yavari HR, Narimani S, Abdolrahimi M, Nezafati S. Effect of premedication with ibuprofen and dexamethasone on success rate of inferior alveolar nerve block for teeth with asymptomatic irreversible pulpitis: a randomized clinical trial. J Endod 2013; 39: 160-2.