Jadhav Ganesh Ranganath, Mittal Priya
Assistant Professor, Department of Conservative Dentistry and Endodontics, SDCH Pune, India .
Senior Resident, Department of Conservative Dentistry and Endodontics, Centre for Dental Education and Research, All India Institute of Medical Sciences , New Delhi, India .
J Clin Diagn Res. 2016 Mar;10(3):ZC15-7. doi: 10.7860/JCDR/2016/16533.7352. Epub 2016 Mar 1.
Clinicians use various anaesthesia techniques like Posterior Superior Alveolar (PSA) nerve block, buccal infiltration with or without supplemental anaesthesia like palatal and intraligamentary infiltrations for root canal treatment in maxillary molars. However there is no general consensus regarding which technique is enough for performing endodontic treatment in maxillary molars.
The aim of this questionnaire-based survey is to compare and evaluate the various techniques used to anaesthetize the maxillary molars and its effect on postoperative pain.
The data were obtained from 290 dental practitioners using a specially prepared questionnaire survey conducted anonymously. The questionnaire contained questions covering data such as years in dentistry, acquired specialty, techniques used for anaesthetizing maxillary molars, success of anaesthesia, and postoperative pain, etc.
Buccal infilteration with supplemental anaesthesia in the form of palatal (82%) and intra-ligamentary infilteration (88%) show higher success rate compared to only buccal infilteration (69%). However, intra-ligamentary infilteration group showed highest rate (75%) of postoperative pain. General practitioners (62% of clinicians) prefer to give both buccal and palatal infilterations and specialists opt for only buccal infilteration (66-74% of specialists).
Only buccal infilteration is sufficient during root canal treatment of maxillary molars. Routine use of supplemental anaesthesia in the form of palatal and intra-ligamentary infilteration is not necessary unless patient experiences discomfort during endodontic treatment. However, intra-ligamentary infilteration may lead to postoperative discomfort in the form of pain.
临床医生在对上颌磨牙进行根管治疗时，会使用多种麻醉技术，如后上牙槽（PSA）神经阻滞、颊侧浸润麻醉，可配合或不配合如腭侧和牙周膜内浸润等辅助麻醉。然而，对于哪种技术足以用于上颌磨牙的牙髓治疗，目前尚无普遍共识。
本基于问卷调查的研究旨在比较和评估用于麻醉上颌磨牙的各种技术及其对术后疼痛的影响。
通过一份专门准备的匿名问卷调查，从290名牙科医生处获取数据。问卷包含的问题涵盖牙科从业年限、获得的专业、麻醉上颌磨牙所用技术、麻醉成功率及术后疼痛等数据。
与单纯颊侧浸润麻醉（69%）相比，采用腭侧浸润（82%）和牙周膜内浸润（88%）作为辅助麻醉的颊侧浸润麻醉成功率更高。然而，牙周膜内浸润麻醉组术后疼痛发生率最高（75%）。全科医生（占临床医生的62%）更倾向于同时进行颊侧和腭侧浸润麻醉，而专科医生则选择仅进行颊侧浸润麻醉（占专科医生的66%-74%）。
在上颌磨牙根管治疗过程中，仅颊侧浸润麻醉就足够了。除非患者在牙髓治疗期间感到不适，否则无需常规使用腭侧和牙周膜内浸润等辅助麻醉。然而，牙周膜内浸润麻醉可能会导致术后疼痛形式的不适。
