Division of Dental Hygiene, University of New Mexico, Albuquerque, NM, USA.
Division of Dental Hygiene, University of New Mexico, Albuquerque, NM, USA
J Dent Hyg. 2024 Oct;98(5):16-21.
The posterior superior alveolar (PSA) block injection is one of many techniques used to provide profound anesthesia for invasive dental procedures. This technique has a high success rate but is not without complication risks. The purpose of this study was to determine if pulpal anesthesia of the maxillary second molar could be achieved using a reduced needle depth of 10mm or 5mm compared to the traditional needle depth of 16mm. Sixty participants were asked to participate in three sessions. Each session started with a pre neural response test, followed by one randomized needle depth PSA injection, and ending with a post neural response test. The neural response test consisted of two parts, a cold refrigerant and a dental probe, on the buccal and interproximal surface of the maxillary second molar. After receiving a positive neural response, each participant received a posterior superior alveolar block injection using a short (21mm), 27-gauge dental needle with a randomized needle penetration depth of 16mm, 10mm, or 5mm. A post neural response test consisting of the same two parts as the pre-test was conducted on the maxillary second molar to evaluate for profound anesthesia. Positive neural responses were obtained from 100% of the participants (n=167) during the pre-tests. Study results demonstrated an 85% success rate at the traditional 16mm needle depth and a 93% and 92% success rates for the reduced needle depths of 10mm and 5mm, respectively. Pulpal anesthesia of the maxillary second molar had been achieved at all three needle depths with no statistically significant difference in the rate of success. Furthermore, there were no adverse events observed. The reduced needle depth technique showed promise in achieving desired results of pulpal anesthesia with a reduced risk for complications associated with the PSA block injection. Additional studies are recommended to achieve evidence-based support for this reduced needle depth technique.
上颌后牙槽（PSA）阻滞注射是用于为侵袭性牙科手术提供深度麻醉的众多技术之一。该技术成功率高，但并非没有并发症风险。本研究旨在确定与传统的 16mm 针深相比，使用 10mm 或 5mm 的减小针深是否可以实现上颌第二磨牙的牙髓麻醉。
要求 60 名参与者参加三个阶段。每个阶段都从神经前反应测试开始，随后进行一次随机的针深 PSA 注射，最后进行神经后反应测试。神经反应测试由颊侧和近中面上颌第二磨牙的冷制冷剂和牙科探针两部分组成。
收到阳性神经反应后，每个参与者都使用短（21mm）、27 号牙用针以随机的针穿透深度 16mm、10mm 或 5mm 接受 PSA 阻滞注射。在对第二磨牙进行与预测试相同的两个部分的神经后反应测试，以评估深度麻醉。在预测试中，100%的参与者（n=167）获得阳性神经反应。
研究结果表明，传统的 16mm 针深的成功率为 85%，而减小的 10mm 和 5mm 针深的成功率分别为 93%和 92%。在所有三个针深都实现了上颌第二磨牙的牙髓麻醉，成功率没有统计学差异。此外，没有观察到不良事件。
减小的针深技术有望在实现牙髓麻醉所需的结果方面取得进展，同时降低与 PSA 阻滞注射相关的并发症风险。建议进行更多的研究，以支持这种减小针深的技术。
