Badr Nelly, Aps Johan
University of Washington, Seattle, USA.
University of Western Australia, Division of Oral Diagnostics and Surgical Sciences, Perth, Australia.
J Dent Anesth Pain Med. 2018 Dec;18(6):319-332. doi: 10.17245/jdapm.2018.18.6.319. Epub 2018 Dec 28.
The objective of this review was to investigate the efficacy of dental local anesthetics, as it is well known among clinicians that local anesthesia may be challenging in some circumstances. Therefore, the focus of this review was on the efficacy of the products used in dental local anesthesia. In a Pubmed database literature search conducted, a total of 8646 articles were found to be related to dental local anesthetics. After having applied the inclusion criteria (human research, performed in the last 10 years, written in English language, and focus on dental local anesthetics) and having assessed the quality of the papers, 30 were deemed eligible for inclusion in this review. The conclusion of this review is that none of the dental local anesthetic amides provide 100% anesthesia. The problem appears to be more pronounced when mandibular teeth are attempted to be anaesthetized and especially if there is irreversible pulpitis involved. The authors conclude that this finding suggest exploration of more efficient techniques to administer dental local anesthesia, especially in the mandible, to establish a 100% efficacy, is needed.
本综述的目的是研究牙科局部麻醉剂的疗效,因为临床医生都清楚,局部麻醉在某些情况下可能具有挑战性。因此,本综述的重点是牙科局部麻醉中使用的产品的疗效。在对PubMed数据库进行文献检索时,共发现8646篇与牙科局部麻醉剂相关的文章。在应用纳入标准(人体研究、过去10年内进行、英文撰写且聚焦于牙科局部麻醉剂)并评估论文质量后,30篇被认为符合纳入本综述的条件。本综述的结论是,没有一种牙科局部麻醉酰胺能提供100%的麻醉效果。当试图麻醉下颌牙齿,尤其是涉及不可逆牙髓炎时,问题似乎更为明显。作者得出结论,这一发现表明需要探索更有效的技术来实施牙科局部麻醉,尤其是在下颌骨,以实现100%的疗效。