Department of Oral and Maxillofacial Surgery, People's College of Dental Sciences and Research Center, People's University, H-3/2, B.D.A Colony, Nayapura, Lal Ghati, Airport Road, 462037 Bhanpur, Bhopal, MP, India.
Department of Oral and Maxillofacial Surgery, People's College of Dental Sciences and Research Center, People's University, H-3/2, B.D.A Colony, Nayapura, Lal Ghati, Airport Road, 462037 Bhanpur, Bhopal, MP, India.
J Stomatol Oral Maxillofac Surg. 2020 Jun;121(3):248-253. doi: 10.1016/j.jormas.2019.07.011. Epub 2019 Jul 20.
Intra-space drug administration have recently gained popularity in the clinical practice posing several advantages over the conventional routes of drug administration. A preliminary prospective randomized triple blind clinical study was conducted to compare the latency and duration of anesthesia with twin mix (1.8ml 2% lignocaine with 1:200,000 epinephrine and 1ml/4mg dexamethasone) and modified twin mix (1.7ml of 4% articaine with 1:100,000 epinephrine and 1ml/4mg dexamethasone) to two conventional local anesthesia solutions along with co-relation of clinical effects in the postoperative phase in patients undergoing extraction of impacted mandibular third molars in terms of patients comfort post-surgery.
The study was conducted among 20 patients with bilateral impacted mandibular third molars who were randomly allotted to two groups, Group A and B. Each patients in both the groups was allotted with study and control site. Among Group A, patients were further divided into Sub-group L (Control) and Sub-group TM (Twin Mix). Group B patients were divided as Sub-group A (Control) and sub-group MTM (Modified Twin Mix). Sub-group L patients received 1.8ml of 2% lignocaine with 1:200,000 adrenaline and sub-group TM received twin mix. Sub-group A received 1.7ml of 4% articaine with 1:100,000 adrenaline and sub-group MTM received modified twin mix solution. All the procedure was performed by a single operator with a gap of 1 month between the two interventions among both the groups. Various subjective and objective parameters were measured pre-operatively and postoperatively to assess the latency and efficacy of various anesthesia solutions used in this study for third molar removal.
Mean (±SD) VAS scores for sting on injection and pain were found to be less in TM and MTM sub-group with a score of 2.3 (±0.768) and 2.7 (±0.065) respectively. The anesthetic latency was significantly less in sub-group TM, with a mean (±SD) of 52.4 (±28.3) seconds. Sub-groups A and MTM had longer latency of anesthesia when compared with L and TM sub-groups. The duration of soft tissue anesthesia was maximum in sub-group MTM as compared to the other sub-groups. Patients from control sub-groups among both the groups had increased swelling, post-surgical pain and trismus postoperatively.
Intra-space administration of twin mix and modified twin mix is clinically efficacious in impacted mandibular third molars surgery with better clinical outcomes postoperatively. We observed one significant difference between TM and MTM that the latter solution provided a prolonged duration of anesthesia increasing the patient's comfort postoperatively after surgical removal of mandibular third molars.
最近， 经皮腔内给药在临床实践中越来越受欢迎， 与传统的药物给药途径相比具有许多优势。 我们进行了一项初步的前瞻性随机三盲临床试验， 比较了双混合剂（2％利多卡因 1.8ml 加 1：200000 肾上腺素和 1ml/4mg 地塞米松）和改良双混合剂（4％阿替卡因 1.7ml 加 1：100000 肾上腺素和 1ml/4mg 地塞米松）与两种常规局部麻醉溶液在麻醉潜伏期和持续时间方面的差异， 并比较了在接受下颌第三磨牙阻生牙拔除术的患者中术后阶段的临床效果， 以评估患者手术后的舒适度。
本研究纳入了 20 名双侧下颌第三磨牙阻生的患者， 他们被随机分为两组， A 组和 B 组。 每组的每位患者都被分配了研究和对照部位。 在 A 组中， 患者进一步分为 L 亚组（对照）和 TM 亚组（双混合剂）。 B 组患者分为 A 亚组（对照）和 MTM 亚组（改良双混合剂）。 L 亚组患者接受 1.8ml 2％利多卡因加 1：200000 肾上腺素， TM 亚组接受双混合剂。 A 亚组患者接受 1.7ml 4％阿替卡因加 1：100000 肾上腺素， MTM 亚组接受改良双混合剂溶液。 所有程序均由一名操作员进行， 两组之间的两次干预间隔为 1 个月。 在术前和术后评估了各种主观和客观参数， 以评估用于第三磨牙拔除的各种麻醉溶液的潜伏期和效果。
在 TM 和 MTM 亚组中， 注射刺痛和疼痛的平均（±SD）VAS 评分分别为 2.3（±0.768）和 2.7（±0.065）， 评分较低。 TM 亚组的麻醉潜伏期明显较短， 平均（±SD）为 52.4（±28.3）秒。 与 L 和 TM 亚组相比， A 和 MTM 亚组的麻醉潜伏期较长。 MTM 亚组的软组织麻醉持续时间最长。 与两组的对照亚组相比， 术后患者肿胀、 术后疼痛和牙关紧闭增加。
经皮腔内给予双混合剂和改良双混合剂在下颌第三磨牙手术中具有临床疗效， 术后临床效果更好。 我们观察到 TM 和 MTM 之间存在一个显著差异， 即后者溶液提供了更长的麻醉持续时间， 增加了患者在接受下颌第三磨牙手术后的舒适度。
