Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Thamar University, Thamar, Yemen.
Department of Oral Surgery and Dental Implantology, College of Dentistry, University of Science and Technology, Sanaa, Yemen.
Clin Oral Investig. 2021 Aug;25(8):4887-4893. doi: 10.1007/s00784-021-03796-w. Epub 2021 Jan 19.
Association between length and gauge of dental needle and success rate and pain perception during an inferior alveolar nerve block (IANB) has not been investigated using a randomized clinical trial (RCT). This RCT aimed to compare the success rate of IANB and perceived pain using 27- or 30-gauge needles for the extraction of adult mandibular molars.
A prospective RCT was conducted on two hundred and twelve adult patients requiring extraction of mandibular molars using standard methods as described by Malamed with 1.8 ml of 2% lidocaine with 1:80,000 adrenaline. One hundred six patients received IANB using 27-gauge needles (32 mm × 0.2 mm) and one hundred six patients received IANB using 30-gauge needles (25 mm × 0.15 mm). Predictor variables were 27-gauge and short and 30-gauge. Outcome variables were the success rate of IANB and pain perception during injection using a visual analogue scale.
There was a highly significantly increase in the success of IANB using 27-gauge needle (95.28%) versus 30-gauge needle (41.51%) (P = 0.001). There was a significant increase in pain perception for patients who received IANB by shorter and thinner needle (30-gauge) when compared to the long and thicker needle (27-gauge).
This RCT demonstrated that 27-gauge needle seems to be associated with a higher success rate of IANB and lower pain perception during injection when compared to 30-gauge needle in the extraction of adult mandibular molars when compared to 30-gauge needles.
For adult patients, when thickness of soft tissue to be penetrated is essential to achieve bony contact, long or large gauge dental needle is preferred to get a higher success rate of IANB with less pain perception during injection.
使用随机临床试验（RCT）尚未研究牙科针的长度和规格与下牙槽神经阻滞（IANB）成功率和疼痛感知之间的关系。本 RCT 旨在比较使用 27 或 30 号针进行成人下颌磨牙拔除时 IANB 的成功率和感知疼痛。
对 212 名需要使用 Malamed 描述的标准方法拔除下颌磨牙的成年患者进行前瞻性 RCT，使用 1.8 ml 2%利多卡因加 1:80,000 肾上腺素。106 例患者接受 27 号针（32mm×0.2mm）IANB，106 例患者接受 30 号针（25mm×0.15mm）IANB。预测变量为 27 号和短号和 30 号。结果变量为 IANB 的成功率和注射时疼痛感知的视觉模拟评分。
使用 27 号针的 IANB 成功率显着增加（95.28%），而使用 30 号针的成功率显着降低（41.51%）（P=0.001）。与长而粗的针（27 号）相比，接受更短更细的针（30 号）IANB 的患者的疼痛感知显着增加。
本 RCT 表明，与 30 号针相比，在拔除成人下颌磨牙时，27 号针似乎与更高的 IANB 成功率和注射时较低的疼痛感知相关。
对于成年患者，当需要穿透的软组织厚度对于达到骨接触至关重要时，长或大规格的牙科针更受欢迎，以提高 IANB 的成功率，并在注射时减少疼痛感知。
