Former Graduate Student in Endodontics, The Ohio State University, Columbus, Ohio.
Emeritus Professor, Division of Endodontics, The Ohio State University, Columbus, Ohio.
Anesth Prog. 2022 Apr 1;69(1):10-17. doi: 10.2344/anpr-68-03-03.
The purpose of this prospective randomized study was to assess using a periodontal ligament (PDL) injection as an aide to decrease palatal infiltration pain.
A total of 133 subjects randomly received a PDL injection and alternative palatal infiltration or a mock PDL injection and conventional palatal infiltration at 2 separate appointments. PDL injection was given in the mid-palatal sulcus of the maxillary first molar. Mock PDL injection consisted of only needle insertion. All subjects then received a palatal infiltration administered into the blanched gingival tissue 3 mm (alternative palatal infiltration) or 7 mm (conventional palatal infiltration) from the gingival collar. Subjects recorded needle insertion and solution deposition pain using a Heft-Parker visual analog scale (VAS).
The combined PDL injection and alternative palatal infiltration had significantly decreased mean VAS ratings for needle insertion and solution deposition pain (P < .0001). Incidence of moderate/severe pain for needle insertion and solution deposition was reduced from 65% to 1% and from 65% to 2%, respectively.
Providing PDL anesthesia into the mid-palatal sulcus of the maxillary first molar and then administering an alternative palatal infiltration into the blanched collar around the PDL molar site led to significant reductions in needle insertion and solution deposition pain compared with a mock PDL and conventional palatal infiltration.
本前瞻性随机研究旨在评估牙周韧带（PDL）注射作为辅助手段，以减轻腭浸润疼痛。
共有 133 名受试者随机分为两组，分别在 2 次就诊时接受 PDL 注射加腭浸润或假 PDL 注射加常规腭浸润。PDL 注射在上颌第一磨牙的腭中嵴处进行。假 PDL 注射仅包括针刺入。然后，所有受试者均接受颊侧浸润注射，注射部位为距龈缘 3mm（替代腭浸润）或 7mm（常规腭浸润）的牙龈苍白组织。受试者使用 Heft-Parker 视觉模拟量表（VAS）记录针刺和溶液沉积疼痛。
联合 PDL 注射和替代腭浸润显著降低了针刺和溶液沉积疼痛的平均 VAS 评分（P<0.0001）。针刺和溶液沉积中度/重度疼痛的发生率从 65%降至 1%和从 65%降至 2%。
在上颌第一磨牙的腭中嵴处给予 PDL 麻醉，然后在 PDL 磨牙部位周围的苍白龈缘处给予替代腭浸润，与假 PDL 和常规腭浸润相比，显著降低了针刺和溶液沉积疼痛。
