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牙周韧带内麻醉与其他浸润麻醉在牙科麻醉效果的比较:系统评价和荟萃分析。

Comparison of dental anesthetic efficacy between the periodontal intraligamentary anesthesia and other infiltration anesthesia: a systematic review and meta-analysis.

机构信息

Sichuan University, State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Chengdu, China.

Sichuan University, State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases & Department of Pediatric Dentistry, West China Hospital of Stomatology, Chengdu, China.

出版信息

PeerJ. 2023 Jul 24;11:e15734. doi: 10.7717/peerj.15734. eCollection 2023.

Abstract

BACKGROUND

Uncertainty exists regarding the pain scores and the success rate of intraligamentary anesthesia compared to other infiltration anesthesia. Based on the conditions of clinical anesthesia techniques, we conducted a systematic review and meta-analysis to compare the efficacy of intraligamentary anesthesia with other infiltration anesthesia.

METHODS

The search was carried out in PubMed Central, Cochrane Central Register of Controlled Trials, MEDLINE (via OVID), Embase (via OVID), and Scopus from the inception to March 26, 2023.

RESULTS

Seven eligible randomized controlled trials were included in the meta-analysis. The results indicated no significant difference in the success rate (RR = 0.96; 95% CI [0.81-1.14]; = 0.65; I= 73%) and visual analog scale (VAS) during dental procedures (MD = 3.81; 95% CI [-0.54-8.16]; = 0.09; I= 97%) between intraligamentary anesthesia and other infiltration anesthesia. However, intraligamentary anesthesia exhibited a higher VAS score during injection than other infiltration anesthesia (MD = 8.83; 95% CI [4.86-12.79];  < 0.0001; I= 90%). A subgroup analysis according to infiltration techniques showed that supraperiosteal anesthesia had a lower VAS score during dental procedures than intraligamentary anesthesia.

CONCLUSIONS

Intraligamentary anesthesia and other infiltration anesthesias have the same success rate and pain during dental procedures. However, the pain during injection of intraligamentary anesthesia is heavier than that of other infiltration anesthesia.

摘要

背景

与其他浸润麻醉相比,关于牙髓内麻醉的疼痛评分和成功率尚存在不确定性。基于临床麻醉技术的条件,我们进行了一项系统评价和荟萃分析,以比较牙髓内麻醉与其他浸润麻醉的疗效。

方法

检索了 PubMed Central、Cochrane 对照试验中心注册库、MEDLINE(通过 OVID)、Embase(通过 OVID)和 Scopus,检索时间截至 2023 年 3 月 26 日。

结果

荟萃分析纳入了 7 项合格的随机对照试验。结果表明,在成功率(RR=0.96;95%CI[0.81-1.14];=0.65;I=73%)和牙齿操作过程中的视觉模拟评分(VAS)(MD=3.81;95%CI[-0.54-8.16];=0.09;I=97%)方面,牙髓内麻醉与其他浸润麻醉之间无显著差异。然而,牙髓内麻醉在注射时的 VAS 评分高于其他浸润麻醉(MD=8.83;95%CI[4.86-12.79];<0.0001;I=90%)。根据浸润技术的亚组分析显示,骨膜上麻醉在牙齿操作过程中的 VAS 评分低于牙髓内麻醉。

结论

牙髓内麻醉和其他浸润麻醉在牙齿操作过程中具有相同的成功率和疼痛程度。然而,牙髓内麻醉注射时的疼痛比其他浸润麻醉更重。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/517f/10373649/e663f18c1800/peerj-11-15734-g002.jpg

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