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骨内注射与下牙槽神经阻滞作为有症状的不可逆性牙髓炎下颌后牙牙髓初次麻醉方法的效果:一项前瞻性随机临床试验

Effect of intraosseous injection versus inferior alveolar nerve block as primary pulpal anaesthesia of mandibular posterior teeth with symptomatic irreversible pulpitis: a prospective randomized clinical trial.

作者信息

Farhad Alireza, Razavian Hamid, Shafiee Maryam

机构信息

a Dental Research Center, Department of Endodontics, School of Dentistry , Isfahan University of Medical Sciences , Isfahan , Iran.

b Department of Endodontics, School of Dentistry , Isfahan University of Medical Sciences , Isfahan , Iran.

出版信息

Acta Odontol Scand. 2018 Aug;76(6):442-447. doi: 10.1080/00016357.2018.1428826. Epub 2018 Jan 27.

Abstract

OBJECTIVE

This study sought to assess the success rate, effect on blood pressure, and pain of intraosseous injection (IO) and inferior alveolar nerve block (IANB) for pulpal anaesthesia of mandibular posterior teeth with symptomatic irreversible pulpitis as the primary anaesthetic technique.

MATERIALS AND METHODS

This randomized clinical trial (IRCT2013022712634N1) was conducted on 60 patients between 18 and 65 years suffering from symptomatic irreversible pulpitis of a mandibular posterior tooth. Patients were randomly divided into two groups. Group one received IO while group two received IANB with 3% mepivacaine. After anaesthetic injection, success rate of pulpal anaesthesia was assessed by pulp testing in the two groups. Systolic and diastolic blood pressures of patients were compared before and after the anaesthetic injections. Level of pain during injection was scored using a visual analogue scale. The data were analyzed using SPSS version 20, t-test and chi square test at p = .05 level of significance.

RESULTS

Success rate of IO (56.7%) was significantly higher than that of IANB (23.3%) (p = .008). There was no significant difference in pain during anaesthetic injection (p = .304) or change in systolic (p = .80) and diastolic (p = .28) blood pressures following injection between the two techniques.

CONCLUSIONS

IO had a higher success rate than IANB for pulpal anaesthesia of mandibular posterior teeth with symptomatic irreversible pulpitis. Neither technique provided profound pulpal anaesthesia.

摘要

目的

本研究旨在评估骨内注射(IO)和下牙槽神经阻滞(IANB)作为主要麻醉技术用于下颌后牙症状性不可逆牙髓炎牙髓麻醉的成功率、对血压的影响及疼痛情况。

材料与方法

本随机临床试验(IRCT2013022712634N1)对60例年龄在18至65岁之间患有下颌后牙症状性不可逆牙髓炎的患者进行。患者被随机分为两组。第一组接受骨内注射,第二组接受含3%甲哌卡因的下牙槽神经阻滞。麻醉注射后,通过牙髓测试评估两组的牙髓麻醉成功率。比较麻醉注射前后患者的收缩压和舒张压。使用视觉模拟量表对注射过程中的疼痛程度进行评分。数据采用SPSS 20版进行分析,采用t检验和卡方检验,显著性水平为p = 0.05。

结果

骨内注射的成功率(56.7%)显著高于下牙槽神经阻滞(23.3%)(p = 0.008)。两种技术在麻醉注射时的疼痛(p = 0.304)或注射后收缩压(p = 0.80)和舒张压(p = 0.28)的变化方面无显著差异。

结论

对于下颌后牙症状性不可逆牙髓炎的牙髓麻醉,骨内注射的成功率高于下牙槽神经阻滞。两种技术均未提供深度牙髓麻醉。

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