Milani Amin Salem, Froughreyhani Mohammad, Rahimi Saeed, Zand Vahid, Jafarabadi Mohammad Asghari
Assistant Professor, Dental and Periodontal Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.
Associate Professor, Department of Endodontics, Faculty of Dentistry, Tabriz University of Medical Sciences, Tabriz, Iran.
Anesth Prog. 2018 Spring;65(1):16-23. doi: 10.2344/anpr-65-01-03.
The aim of this study was to provide an evidence-based answer to the question: "Is 3.6-mL volume of an anesthetic agent more effective than 1.8-mL volume in providing anesthesia for mandibular molars?" Following formulation of research question and keyword selection, a comprehensive search of the following databases was conducted: Cochrane library, PubMed, Scopus, Google Scholar, ProQuest, and Clinicaltrials.gov. Three-phase eligibility appraisal and quality assessment of the studies were carried out by 2 independent reviewers. To reduce clinical heterogeneity, the included studies were divided into 2 groups: studies on healthy teeth and studies on teeth with pulpitis. The data of included studies were statistically combined through meta-analysis using a fixed-effects model. A total of 20,778 records were initially retrieved from the search. Following screening and eligibility assessment, 8 studies met the eligibility criteria and were included for qualitative synthesis. Of those, 5 studies were qualified for meta-analysis. In the irreversible pulpitis group, increasing the volume of anesthetic agent from 1.8 to 3.6 mL significantly increased the success rate of inferior alveolar nerve block (risk ratio = 2.45, 95% CI: 1.67-3.59, p < .001). However, there was insufficient evidence to draw a conclusion regarding healthy teeth.
“在为下颌磨牙提供麻醉时，3.6毫升麻醉剂的效果是否比1.8毫升麻醉剂更有效？”在提出研究问题并选择关键词后，对以下数据库进行了全面检索：Cochrane图书馆、PubMed、Scopus、谷歌学术、ProQuest和Clinicaltrials.gov。由2名独立评审员对研究进行了三阶段的合格性评估和质量评估。为减少临床异质性，将纳入的研究分为两组：健康牙齿的研究和牙髓炎牙齿的研究。使用固定效应模型通过荟萃分析对纳入研究的数据进行统计学合并。最初从检索中获得了总共20778条记录。经过筛选和合格性评估，8项研究符合合格标准并被纳入定性综合分析。其中，5项研究符合荟萃分析的条件。在不可逆性牙髓炎组中，将麻醉剂的体积从1.8毫升增加到3.6毫升显著提高了下牙槽神经阻滞的成功率（风险比=2.45，95%可信区间：1.67-3.59，p<.001）。然而，没有足够的证据就健康牙齿得出结论。
