Department of Oral and Maxillofacial Surgery, Facial Plastic Surgery, University Medical Centre Rostock, Schillingalle 35, 18057, Rostock, Germany.
Policlinic of Oral Surgery, University Medical Centre Mainz, Mainz, Germany.
Clin Oral Investig. 2018 Apr;22(3):1469-1475. doi: 10.1007/s00784-017-2248-2. Epub 2017 Oct 15.
The aim of the study was to compare the efficacy of intraligamentary anesthesia (ILA) with conventional inferior alveolar nerve block (IANB) for extraction of mandibular posterior teeth.
In a prospective clinical trial, a total of 301 mandibular posterior teeth were extracted in 266 patients. Randomization was conducted into those who received ILA (patients n = 98; teeth n = 105) and those who received IANB (patient n = 140; teeth n = 140). Twenty-eight patients were subjected to bilateral mandibular dental extractions and received both ILA und IANB (teeth n = 56 (ILA n = 28; IANB n = 28)). The primary objective was to evaluate the differences in pain during injection, in pain during tooth extraction (numeric rating scale (NRS)), and in anesthetic quality (complete/sufficient vs. insufficient/no effect). Differences in latency time, amount of anesthetic solution, need for second injection, and duration of local numbness as well as in the incidence of dry socket were assessed.
ILA had significant lower pain of injection (p < 0.001), shorter latency time (p < 0.001), and shorter duration of local numbness (p < 0.001) and required lesser amount of local anesthetic solution (p < 0.001) together with a similar anesthetic quality (p = 0.082) compared to IANB. Concerning pain during extraction (p = 0.211), frequency of second injection (p = 0.197), and incidence of dry socket (p = 0.178), no significant differences were detected.
ILA fulfills the requirements of a minimal invasive and patient-friendly local anesthetic technique. In accordance, it represents a safe and reliable alternative to IANB for extraction of mandibular posterior teeth.
ILA can be recommended for routine dental extractions.
本研究旨在比较结扎内麻醉（ILA）与传统下齿槽神经阻滞（IANB）在拔除下颌后牙中的疗效。
在一项前瞻性临床试验中，共对 266 例患者的 301 颗下颌后牙进行了拔除。将接受 ILA（患者 n=98；牙齿 n=105）和接受 IANB（患者 n=140；牙齿 n=140）的患者进行随机分组。28 例患者接受双侧下颌牙齿拔除，并同时接受 ILA 和 IANB（牙齿 n=56（ILA n=28；IANB n=28））。主要目的是评估注射时疼痛、拔牙时疼痛（数字评分量表（NRS））和麻醉质量（完全/充足与不足/无效）的差异。评估潜伏期、麻醉剂用量、第二次注射需要、局部麻木持续时间以及干槽症发生率的差异。
ILA 在注射疼痛（p<0.001）、潜伏期（p<0.001）和局部麻木持续时间（p<0.001）较短，需要较少的局部麻醉剂（p<0.001），同时麻醉质量相似（p=0.082）与 IANB 相比，疼痛明显较低。关于拔牙时的疼痛（p=0.211）、第二次注射的频率（p=0.197）和干槽症的发生率（p=0.178），没有发现显著差异。
ILA 满足微创和患者友好型局部麻醉技术的要求。因此，它是下颌后牙拔除术的 IANB 的安全可靠替代方案。
ILA 可推荐用于常规拔牙。
