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4% 阿替卡因与 2% 盐酸利多卡因用于磨牙-切牙牙本质发育不全患牙根管治疗的麻醉效果比较。

Anesthetic efficacy of 4% articaine versus 2% lignocaine in root canal treatment of teeth with molar incisor hypomineralization.

机构信息

Department of Pediatric and Preventive Dentistry, PMS College of Dental Science and Research, Thiruvananthapuram, Kerala, India.

出版信息

J Indian Soc Pedod Prev Dent. 2023 Oct 1;41(4):316-321. doi: 10.4103/jisppd.jisppd_375_23. Epub 2024 Jan 18.

Abstract

CONTEXT

Inferior alveolar nerve block (IANB) is considered the cornerstone in achieving anesthesia for mandibular molars. However, failure of routine lignocaine IANB to achieve profound anesthesia of the pulp has been reported in patients with molar incisor hypomineralization (MIH). Articaine 4% with epinephrine 1:100,000 has proven to provide total pain relief during most dental procedures.

AIMS

This study aimed to assess and compare the pain perception level in children using Visual Analog Scale (VAS) during root canal treatment after administering 4% articaine buccal infiltration (BI), 4% articaine IANB, and 2% lignocaine IANB.

SUBJECTS AND METHODS

Twenty-seven children aged 8-12 years, requiring root canal treatment of mandibular first permanent molars with MIH were randomly allocated into three groups - 4% articaine (1:100,000 epinephrine) BI, 4% articaine (1:100,000 epinephrine) IANB, and 2% lignocaine IANB. The efficacy of the anesthetic was determined by rating the pain perception of the child using a VAS.

STATISTICAL ANALYSIS USED

The scores marked by the children on the VAS were recorded and were statistically analyzed. Data were entered into Microsoft excel data sheet and were analyzed using SPSS for Windows version 17.0.

RESULTS

Patients anesthetized with 4% articaine IANB presented lesser pain scores compared to IANB with 2% lidocaine and 4% articaine BI on access opening and instrumentation of the root canals.

CONCLUSION

4% articaine IANB has better anesthetic efficacy than 4% articaine BI and 2% lignocaine IANB in anesthetising mandibular first permanent molars with MIH.

摘要

背景

下牙槽神经阻滞(IANB)被认为是实现下颌磨牙麻醉的基石。然而,有报道称,在患有摩尔切牙发育不全(MIH)的患者中,常规使用利多卡因 IANB 无法实现牙髓的深度麻醉。4%的阿替卡因加 1:100000 的肾上腺素已被证明在大多数牙科手术中能提供完全的止痛效果。

目的

本研究旨在评估和比较在接受颊侧浸润(BI)4%阿替卡因、IANB 4%阿替卡因和 IANB 2%利多卡因后,使用视觉模拟量表(VAS)评估儿童在根管治疗期间的疼痛感知水平。

受试者和方法

27 名 8-12 岁的儿童,需要对下颌第一恒磨牙进行根管治疗,患有 MIH,随机分为三组:BI 4%阿替卡因(1:100000 肾上腺素)、IANB 4%阿替卡因(1:100000 肾上腺素)和 IANB 2%利多卡因。通过 VAS 评估儿童的疼痛感知来确定麻醉效果。

统计学分析方法

记录儿童在 VAS 上标记的分数,并进行统计学分析。数据输入 Microsoft excel 数据表,并使用 SPSS for Windows 版本 17.0 进行分析。

结果

在开口和根管器械操作时,接受 IANB 4%阿替卡因麻醉的患者的疼痛评分低于 IANB 2%利多卡因和 BI 4%阿替卡因。

结论

在麻醉 MIH 下颌第一恒磨牙时,IANB 4%阿替卡因比 BI 4%阿替卡因和 IANB 2%利多卡因具有更好的麻醉效果。

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