Jaju Krishna Kanth, Nasim Iffat, Choudhari Sahil, Sandeep A Hima
Conservative Dentistry and Endodontics, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences (SIMATS) Saveetha University, Chennai, IND.
Cureus. 2024 Feb 21;16(2):e54661. doi: 10.7759/cureus.54661. eCollection 2024 Feb.
Introduction Pain is the primary reason for which most of the patients seek endodontic treatment. Local anesthesia is considered to be the most important step in the procedure to reduce the pain. However, the majority of the patients do not cooperate due to the fear of syringe anesthesia. The aim of this clinical trial was to compare the anesthetic efficacy of needle-free anesthesia and conventional anesthesia in patients with symptomatic irreversible pulpitis undergoing root canal therapy. Materials and methods A total of 54 patients were enrolled in the study, and the treatment was administered by a single operator. The initial assessment of vitality included cold testing, heat testing, and electric pulp testing. Preoperative pain was assessed using the Visual Analog Scale (VAS) before the administration of anesthesia. Local anesthesia was administered according to the group assigned: Group 1 (conventional anesthesia) and Group 2 (needle-free anesthesia). The pain was assessed during the administration of anesthesia. Following the administration of anesthesia, the vitality of the tooth was evaluated using cold testing, heat testing, and electric pulp testing. Subsequently, the tooth was isolated with a rubber dam, and the access cavity was prepared. The pain was assessed during access cavity preparation and during the first file insertion. Working length was determined using an apex locator (Root ZX Mini, J Morita, Saitama, Japan) and was confirmed using intraoral periapical radiographs. Later on, further treatment was carried out. Results A total of 54 participants were included in this clinical trial. There was no significant difference in mean age distribution between the two groups (p=0.852). Considering the frequency distribution of gender, there was no significant difference; however, Group 1 had more female participants (59.3%) compared to Group 2 (33.3%). There was a significant reduction in the mean pain score in Group 2 compared to Group 1 during the delivery of anesthetic agents (p=0.000). Conclusion Needle-free anesthesia proves to be equally effective as the conventional syringe system in patients experiencing symptomatic irreversible pulpitis undergoing root canal treatment. However, it is noteworthy that patients exhibited greater comfort levels with needle-free anesthesia systems specifically during the administration of the anesthetic solution.
引言
疼痛是大多数患者寻求牙髓治疗的主要原因。局部麻醉被认为是该治疗过程中减轻疼痛的最重要步骤。然而，由于害怕注射器麻醉，大多数患者并不配合。本临床试验的目的是比较在接受根管治疗的有症状不可逆性牙髓炎患者中，无针麻醉与传统麻醉的麻醉效果。
材料与方法
本研究共纳入54例患者，且治疗由一名操作者进行。初始活力评估包括冷诊、热诊和牙髓电活力测试。在麻醉给药前，使用视觉模拟评分法（VAS）评估术前疼痛。根据分组进行局部麻醉：第1组（传统麻醉）和第2组（无针麻醉）。在麻醉给药过程中评估疼痛。麻醉给药后，使用冷诊、热诊和牙髓电活力测试评估牙齿的活力。随后，用橡皮障隔离患牙，并制备开髓腔。在制备开髓腔和插入第一根锉时评估疼痛。使用根尖定位仪（Root ZX Mini，日本森田株式会社，埼玉）确定工作长度，并通过口内根尖片进行确认。随后进行进一步治疗。
结果
本临床试验共纳入54名参与者。两组的平均年龄分布无显著差异（p = 0.852）。考虑性别频率分布，无显著差异；然而，第1组女性参与者（59.3%）比第2组（33.3%）更多。在麻醉剂给药期间，第2组的平均疼痛评分与第1组相比显著降低（p = 0.000）。
结论
对于接受根管治疗的有症状不可逆性牙髓炎患者，无针麻醉与传统注射器系统同样有效。然而，值得注意的是，患者在使用无针麻醉系统时，尤其是在麻醉剂给药期间，舒适度更高。
