Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Erciyes University, Kayseri, Turkey.
Med Oral Patol Oral Cir Bucal. 2011 May 1;16(3):e386-9. doi: 10.4317/medoral.16.e386.
There is no agreement on using inferior alveolar nerve (IAN) block or supraperiosteal infiltration anesthesia during dental implant surgery in the posterior mandibular region. The aim of this study was to evaluate the effectiveness of supraperiosteal infiltration anesthesia on posterior mandibular region during dental implant surgery.
In this study 52 implants were inserted under supraperiosteal infiltration anesthesia in 29 patients. After the surgery, patients were instructed to note their pain and/or painless dyscomfort on the visual analogue scale (VAS). Their pressure pain threshold (PPT) scores were evaluated by mechanical algometer. The distance between the apical end of the implants and IAN was measured by using calipers on postoperatif panoramic radiographs.
50 implants to 27 patients had been able to place without pain under supraperiosteal infiltration. Implants which were placed at the mandibular second premolar and first molar region had been able to place with free of pain with supraperiosteal infiltration. There was no relationship among the distance between the apical ends of the implants and IAN with intraoperative discomfort of the patients. VAS scores during implant placement at the second premolar region were relatively higher than at the first and second molar region.
Supraperiosteal infiltration anesthesia is a safe and effective method for posterior mandibular implant surgery. However the length of the implant should be determined carefully to avoid possible damage to IAN during implant placement under supraperiosteal infiltration anesthesia.
在下颌后牙区的种植手术中，使用下牙槽神经阻滞麻醉或骨膜上浸润麻醉尚无定论。本研究旨在评估骨膜上浸润麻醉在下颌后牙区种植手术中的有效性。
本研究中，29 名患者共 52 个种植体在下颌骨骨膜上浸润麻醉下植入。手术后，患者使用视觉模拟评分法（VAS）记录疼痛和/或无痛不适程度。使用机械压痛计评估其压力疼痛阈值（PPT）评分。术后全景片上用卡尺测量种植体根尖末端和下牙槽神经之间的距离。
27 名患者的 50 个种植体在骨膜上浸润麻醉下无痛植入。下颌第二前磨牙和第一磨牙区的种植体在骨膜上浸润麻醉下可无痛植入。种植体根尖末端与下牙槽神经之间的距离与患者术中不适无相关性。第二前磨牙区种植体植入时的 VAS 评分相对高于第一和第二磨牙区。
骨膜上浸润麻醉是一种安全有效的下颌后牙种植手术方法。然而，在骨膜上浸润麻醉下植入种植体时，应仔细确定种植体的长度，以避免可能对下牙槽神经造成损伤。
