Kämmerer P W, Schiegnitz E, von Haussen T, Shabazfar N, Kämmerer P, Willershausen B, Al-Nawas B, Daubländer M
Department of Oral, Maxillofacial and Plastic Surgery, University Medical Centre Rostock, Rostock, Germany.
Eur J Dent Educ. 2015 Feb;19(1):16-22. doi: 10.1111/eje.12096. Epub 2014 Mar 20.
To evaluate the impact of experience whilst using different devices for intraligamentary anaesthesia, dental students tested clinical anaesthetic efficacy of a mechanical (PDL-S) and a computer-controlled (CCLAD) application system in restorative patients.
In a prospective study, 41 Patients in need of restorative treatment in lower posterior mandible were randomised into three groups (PDL-S: teeth n = 22; CCLAD: teeth n = 20; inferior alveolar nerve block (IANB): teeth n = 20). Dental last year students conducted anaesthesia and dental treatment. Primary objectives were differences in pain during treatment [numeric rating scale (NRS)] as well as in anaesthetic efficacy (complete/sufficient vs. insufficient/no effect) between PDL-S and CCLAD. Pain of injection, need for second injections, amount of anaesthetic solution and duration of local numbness were assessed. IANB as gold standard was compared to each system descriptively.
PDL-S had a significant lower pain during treatment (P = 0.017) but a similar anaesthetic efficacy (P = 0.175) compared to the CCLAD system. Concerning pain of injection (P = 0.42), quantity of second injections (P = 0.232), amount of used solution (P = 0.073) as well as duration of local numbness (P = 0.253), no differences were seen. When comparing both periodontal ligament injection (PDL)-systems with IANB, pain rating was higher when using CCLAD. Injection pain, amount of used solution as well as soft tissue anaesthesia was less for PDL-S and CCLAD.
Both PDL techniques showed a good success for dental routine treatments. Although, compared to the mechanic device, the CCLAD system might need more clinical daily experience.
We recommend including specific trainings in intraligamentary anaesthesia in the dental curriculum.
为评估使用不同器械进行韧带内麻醉时经验的影响，牙科学生测试了机械（PDL-S）和计算机控制（CCLAD）应用系统在修复患者中的临床麻醉效果。
在一项前瞻性研究中，41名下颌后牙需要进行修复治疗的患者被随机分为三组（PDL-S组：牙齿n = 22；CCLAD组：牙齿n = 20；下牙槽神经阻滞（IANB）组：牙齿n = 20）。牙科四年级学生进行麻醉和牙科治疗。主要目标是比较PDL-S组和CCLAD组在治疗期间的疼痛差异[数字评分量表（NRS）]以及麻醉效果（完全/充分与不充分/无效）。评估注射疼痛、二次注射需求、麻醉剂溶液用量和局部麻木持续时间。将IANB作为金标准与每个系统进行描述性比较。
与CCLAD系统相比，PDL-S在治疗期间的疼痛明显更低（P = 0.017），但麻醉效果相似（P = 0.175）。在注射疼痛（P = 0.42）、二次注射量（P = 0.232）、所用溶液量（P = 0.073）以及局部麻木持续时间（P = 0.253）方面，未发现差异。当将两种牙周韧带注射（PDL）系统与IANB进行比较时，使用CCLAD时疼痛评分更高。PDL-S和CCLAD的注射疼痛、所用溶液量以及软组织麻醉效果均较小。
两种PDL技术在牙科常规治疗中均显示出良好的效果。尽管与机械装置相比，CCLAD系统可能需要更多的临床日常经验。
我们建议在牙科课程中纳入韧带内麻醉的特定培训。
