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在下颌乳磨牙牙髓治疗中,阿替卡因颊侧浸润麻醉与利多卡因下牙槽神经阻滞麻醉的效果评估。

Evaluation of Buccal Infiltration with Articaine and Inferior Alveolar Nerve Block with Lignocaine for Pulp Therapy in Mandibular Primary Molars.

作者信息

Chopra Radhika, Marwaha Mohita, Bansal Kalpana, Mittal Meenu

出版信息

J Clin Pediatr Dent. 2016;40(4):301-5. doi: 10.17796/1053-4628-40.4.301.

Abstract

OBJECTIVE

Failure of inferior alveolar nerve block in achieving profound anesthesia of the pulp due to various reasons has led to the introduction of more potent local anesthetic agents like articaine. This study was conducted to compare the efficacy of buccal infiltration with articaine in achieving pulpal anesthesia of primary molars as compared to inferior alveolar nerve block with lignocaine.

STUDY DESIGN

30 patients (4-8 years) with indication of pulp therapy in at least two mandibular primary molars were selected. Patients were randomly assigned to receive nerve block with lignocaine or infiltration with articaine on first appointment and the other solution on second appointment. All the pulpotomies and pulpectomies were performed by a pediatric dentist. Two researchers standing at a distance of 1.5 m recorded the Pain Scores and Sound, Eye, Motor (SEM) scores. After the completion of procedure, the patient was asked to record the Facial Image score and Heft-Parker Visual Analogue Score (HP-VAS).

RESULTS

Pain Score recorded at the time of injection showed significantly more movements with block as compared to infiltration (p<0.001). SEM scores at time of pulp extirpation were also higher for block than infiltration (p<0.001).

CONCLUSION

Articaine infiltration has the potential to replace inferior alveolar nerve block for primary mandibular molars.

摘要

目的

由于各种原因,下牙槽神经阻滞未能实现牙髓的深度麻醉,这促使了如阿替卡因等更强效局部麻醉剂的引入。本研究旨在比较阿替卡因颊侧浸润与利多卡因下牙槽神经阻滞在实现下颌乳磨牙牙髓麻醉方面的效果。

研究设计

选取30例(4 - 8岁)至少两颗下颌乳磨牙有牙髓治疗指征的患者。患者被随机分配,首次就诊时接受利多卡因神经阻滞或阿替卡因浸润,第二次就诊时接受另一种溶液。所有的活髓切断术和牙髓摘除术均由一名儿童牙医进行。两名站在1.5米远处的研究人员记录疼痛评分和声音、眼睛、运动(SEM)评分。手术完成后,要求患者记录面部图像评分和赫夫特 - 帕克视觉模拟评分(HP - VAS)。

结果

注射时记录的疼痛评分显示,与浸润相比,阻滞时的运动明显更多(p<0.001)。牙髓摘除时的SEM评分阻滞也高于浸润(p<0.001)。

结论

阿替卡因浸润有可能取代下颌乳磨牙的下牙槽神经阻滞。

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