Alali Ahmed I, Lopez Gross Jacqueline, Al-Sumaidaee Mustafa Ayad, Wong Michelle, Feng Sean Xinyang, Cherkas Pavel S, Basrani Bettina R
Faculty of Dentistry, University of Toronto, Toronto, ON M5G 1G6, Canada.
Private Practice, London, ON N6B 2P9, Canada.
Dent J (Basel). 2025 May 27;13(6):238. doi: 10.3390/dj13060238.
: Although many studies have demonstrated the effectiveness of intraosseous anesthesia (IOA), the experience of clinicians administering IOA has rarely been reported. Some endodontists may never have received formal training in IOA, raising questions about whether inexperienced clinicians can achieve similar results. Although the previous studies suggest that limited experience may increase the risk of complications, the extent to which clinician experience influences IOA outcomes remains uncertain. This study sought to assess whether clinician experience affects the effectiveness, patient comfort, and safety of IOA in endodontic treatment. : This retrospective cohort study included 72 patients who had previously undergone endodontic treatment or retreatment for mandibular molars. Of these, 37 were treated by an endodontic resident with limited IOA experience, and 35 by an endodontist with extensive IOA experience. IOA was administered using the QuickSleeper 5 system (Dental Hi Tec, Cholet Cedex, France) as the sole anesthetic technique before the start of the endodontic treatment or retreatment. Pain assessments were recorded preoperatively (baseline), during IOA administration, and during the treatment. Statistical analyses included binomial and chi-square tests to compare the success rates and associations between the clinician experience and the IOA outcomes. Statistical significance was set at < 0.05. : Pain during IOA administration was reported as none or mild in 98.6% of the patients, with no significant difference between the endodontist (97.2%) and resident (100%) groups ( = 0.378). Profound anesthesia was achieved in 94.1% of the cases, with no significant difference between the endodontist (96.8%) and resident (91.9%) groups ( = 0.738). Complications were rare, with two cases of perforator separation (5.4%) in the resident group; nevertheless, clinician experience was not significantly associated with complications ( = 0.553). Conclusions: Within the limitations of this study, clinician experience did not significantly affect the IOA outcomes, including effectiveness, patient comfort, and safety. These findings suggest that IOA can be used effectively by clinicians with different levels of experience, thus supporting its broader implementation in endodontic practice.
尽管许多研究已证明骨内麻醉（IOA）的有效性，但临床医生实施IOA的经验却鲜有报道。一些牙髓病医生可能从未接受过IOA的正规培训，这引发了关于缺乏经验的临床医生能否取得类似效果的疑问。尽管先前的研究表明经验有限可能会增加并发症的风险，但临床医生经验对IOA结果的影响程度仍不确定。本研究旨在评估临床医生经验是否会影响牙髓治疗中IOA的有效性、患者舒适度和安全性。
这项回顾性队列研究纳入了72例先前接受过下颌磨牙牙髓治疗或再治疗的患者。其中，37例由IOA经验有限的牙髓科住院医生治疗，35例由IOA经验丰富的牙髓病医生治疗。在牙髓治疗或再治疗开始前，使用QuickSleeper 5系统（法国肖莱塞德克斯的Dental Hi Tec公司）作为唯一的麻醉技术进行IOA。在术前（基线）、IOA给药期间和治疗期间记录疼痛评估情况。统计分析包括二项式检验和卡方检验，以比较成功率以及临床医生经验与IOA结果之间的关联。设定统计学显著性为<0.05。
98.6%的患者报告在IOA给药期间无疼痛或疼痛轻微，牙髓病医生组（97.2%）和住院医生组（100%）之间无显著差异（P = 0.378）。94.1%的病例实现了深度麻醉，牙髓病医生组（96.8%）和住院医生组（91.9%）之间无显著差异（P = 0.738）。并发症很少见，住院医生组有2例穿孔器分离（5.4%）；然而，临床医生经验与并发症无显著关联（P = 0.553）。
在本研究的局限性范围内，临床医生经验并未显著影响IOA结果，包括有效性、患者舒适度和安全性。这些发现表明，不同经验水平的临床医生均可有效使用IOA，从而支持其在牙髓治疗实践中的更广泛应用。
