Ghoddusi Jamileh, Zarrabi Mohammad Hasan, Daneshvar Farzaneh, Naghavi Neda
Dental Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.
Endodontist, Private Practice, Mashhad, Iran.
Iran Endod J. 2018 Spring;13(2):143-148. doi: 10.22037/iej.v13i2.18625.
The aim of the present study was to compare the efficacy of the inferior alveolar nerve block (IANB) and Gow-Gates techniques in mandibular molars with symptomatic irreversible pulpitis.
In this randomised, double-blind clinical trial, 80 patients referred to Mashhad Dental School, were randomly divided into two groups: IANB and Gow-Gates anaesthetic techniques using 2% lidocaine with 1:100000 epinephrine. After injection, if pain during caries/dentin removal and access cavity preparation was reported in each group, the patients once again were randomly allocated to receive buccal or lingual supplementary infiltration. Pain severity was evaluated using a visual analogue scale. The rates of positive aspiration and changes in heart rate were compared between the IANB and Gow-Gates. Paired and individual -tests and the Mann-Whitney -test were used to compare the reduction in pain severity. The level of significance was set at 0.05.
The success rates of anaesthesia in the Gow-Gates and IANB techniques were 50% and 42.5%, respectively with no significant difference =0.562). Supplementary infiltrations significantly reduced pain severity in all subgroups (<0.05). Lingual infiltration resulted in a significantly greater reduction in pain severity in the IANB group than in the Gow-Gates group (<0.05). No significant difference in heart rate or positive aspiration results was observed between groups (>0.05).
In the present study, the efficacy of the IANB and Gow-Gates techniques was comparable in mandibular molars with symptomatic irreversible pulpitis. Supplementary buccal and lingual infiltration significantly reduced pain severity.
本研究旨在比较下牙槽神经阻滞（IANB）和Gow-Gates技术在下颌磨牙症状性不可逆性牙髓炎治疗中的疗效。
在这项随机双盲临床试验中，80名转诊至马什哈德牙科学院的患者被随机分为两组：分别采用含1:100000肾上腺素的2%利多卡因进行IANB和Gow-Gates麻醉技术。注射后，若每组在龋洞/牙本质去除及开髓预备过程中出现疼痛，则患者再次被随机分配接受颊侧或舌侧补充浸润麻醉。使用视觉模拟量表评估疼痛严重程度。比较IANB组和Gow-Gates组的阳性回抽率及心率变化。采用配对和个体t检验以及Mann-Whitney U检验比较疼痛严重程度的降低情况。显著性水平设定为0.05。
Gow-Gates技术和IANB技术的麻醉成功率分别为50%和42.5%，无显著差异（P=0.562）。补充浸润麻醉在所有亚组中均显著降低了疼痛严重程度（P<0.05）。IANB组舌侧浸润导致的疼痛严重程度降低显著大于Gow-Gates组（P<0.05）。两组间心率或阳性回抽结果无显著差异（P>0.05）。
在本研究中，IANB技术和Gow-Gates技术在下颌磨牙症状性不可逆性牙髓炎治疗中的疗效相当。颊侧和舌侧补充浸润麻醉显著降低了疼痛严重程度。
