Goldberg Steven, Reader Al, Drum Melissa, Nusstein John, Beck Mike
Deceased.
Division of Endodontics, The Ohio State University, Columbus, Ohio.
J Endod. 2008 Nov;34(11):1306-1311. doi: 10.1016/j.joen.2008.07.025. Epub 2008 Aug 30.
The purpose of this prospective, randomized study was to compare the degree of pulpal anesthesia obtained with the conventional inferior alveolar, the Gow-Gates, and the Vazirani-Akinosi techniques in vital, asymptomatic teeth. With a crossover design, 40 subjects received all 3 techniques in a random manner by using 3.6 mL of 2% lidocaine with 1:100,000 epinephrine at 3 separate appointments. An electric pulp tester was used to test for anesthesia in 3-minute cycles for 60 minutes of the first molars, first premolars, and lateral incisors. Anesthesia was considered successful when 2 consecutive 80 readings were obtained within 15 minutes, and the 80 reading was continuously sustained through the 60th minute. The ranges of successful anesthesia were as follows: inferior alveolar technique, 25%-62%; Gow-Gates technique, 16%-44%; and for the Vazirani-Akinosi technique, 13%-50%. There was no significant difference (P > .05) in success among the 3 techniques. However, the Gow-Gates and Vazirani-Akinosi techniques resulted in a statistically slower onset of pulpal anesthesia than the inferior alveolar nerve block. We concluded that in vital, asymptomatic teeth and for the subjects who achieved lip numbness, the conventional inferior alveolar nerve block is similar to the Gow-Gates and Vazirani-Akinosi techniques regarding anesthetic success but has a faster onset of pulpal anesthesia.
这项前瞻性随机研究的目的是比较在活髓、无症状牙齿中，传统下牙槽神经阻滞、Gow-Gates技术和Vazirani-Akinosi技术所获得的牙髓麻醉程度。采用交叉设计，40名受试者在3次单独就诊时，以随机方式接受了所有3种技术，均使用3.6 mL含1:100,000肾上腺素的2%利多卡因。使用牙髓电活力测试仪，对第一磨牙、第一前磨牙和侧切牙进行60分钟的测试，每3分钟循环测试一次麻醉情况。当在15分钟内连续获得2次80的读数，且该80的读数持续维持到第60分钟时，麻醉被认为成功。成功麻醉的范围如下：下牙槽神经阻滞技术为25%-62%；Gow-Gates技术为16%-44%；Vazirani-Akinosi技术为13%-50%。这3种技术在成功率上没有显著差异（P>.05）。然而，Gow-Gates技术和Vazirani-Akinosi技术导致牙髓麻醉的起效在统计学上比下牙槽神经阻滞更慢。我们得出结论，在活髓、无症状牙齿且实现唇部麻木的受试者中，传统下牙槽神经阻滞在麻醉成功率方面与Gow-Gates技术和Vazirani-Akinosi技术相似，但牙髓麻醉起效更快。
