Itoman Erick M, Kajioka Eric H, Yamamoto Loren G
Department of Pediatrics, University of Hawaii John A. Burns School of Medicine Emergency Department, Kapiolani Medical Center For Women and Children, Honolulu, 96826, USA.
Am J Emerg Med. 2005 Mar;23(2):186-9. doi: 10.1016/j.ajem.2004.03.007.
Dental fracture is a complication of laryngoscopy and endotracheal intubation.
The purpose of this study is to compare the potential fracture rates in dental models using metal laryngoscope blades with those using plastic laryngoscope blades.
Size 3 Macintosh plastic and metal laryngoscope blades were applied against 4 different dental model materials at varying torques to determine when the dental model material would fracture.
The plastic blade did not fracture any of the dental model materials. The metal blade fractured the glass dental model material even at the lowest torque setting. At a moderate torque setting, the plastic blade showed evidence of structural failure, whereas the metal blade did not fail at any torque setting. Fracture of wooden dowel and ceramic teeth model materials occurred with the metal blade but only at torque settings higher than what the plastic blade could achieve.
Based on the dental fracture models studied, plastic laryngoscope blades have a lower potential for dental fracture compared with metal blades. Plastic laryngoscope blades would be best suited for trainees performing routine intubations under direct supervision. Metal blades would be more advantageous in difficult intubations preferably done by experienced intubators.