Smith G N, Walton R E, Abbott B J
J Am Dent Assoc. 1983 Dec;107(6):953-6. doi: 10.14219/jada.archive.1983.0357.
Conventional local anesthesia techniques are frequently unsuccessful, particularly for endodontic procedures. Supplementary injections are often necessary; the periodontal ligament injection is useful for this purpose. This study examined the effectiveness of injecting into the periodontal ligament with a pistol-type pressure syringe as a supplemental technique in patients who did not have adequate anesthesia for endodontic therapy. Sixty patients received the supplemental injections and 20 patients were reinjected when the first PDL injection failed. Data were obtained by questionnaire. Percentages were computed and comparisons made by X2 analysis. The conclusions about attaining anesthesia included: --Needle size was not important; overall, 25- and 30-gauge needles were equivalent. --Injecting under strong back-pressure was important; the greatest frequency of success was attained when injecting under pressure. Lack of back-pressure on both mesial and distal surfaces resulted in a significantly lower incidence of anesthesia. Proper positioning of the needle and maintaining this position, to force the anesthetic deep into the periodontium, is apparently an effective way to generate the needed back-pressure. --Strong back-pressure could usually be attained on either or both surfaces. --Reinjection was frequently successful if the first periodontal ligament injection failed. --Overall frequency of success in attaining anesthesia with the pistol-type pressure syringe was 83%. This was determined by including the instances in which reinjection was necessary. --Comparing the results of this study with a previous similar study, the pressure syringe were equally effective for supplementary anesthesia.
传统的局部麻醉技术常常不成功，尤其是在牙髓治疗中。通常需要追加注射；牙周韧带注射在这方面很有用。本研究考察了使用手枪式压力注射器向牙周韧带注射作为一种补充技术在牙髓治疗麻醉不足患者中的有效性。60例患者接受了追加注射，20例患者在首次牙周韧带注射失败后再次注射。通过问卷调查获取数据。计算百分比并通过卡方分析进行比较。关于实现麻醉的结论包括：——针头大小并不重要；总体而言，25号和30号针头效果相当。——在强大的回压下注射很重要；在压力下注射时成功率最高。近中和远中表面均缺乏回压会导致麻醉发生率显著降低。将针头正确定位并保持该位置，以使麻醉剂深入牙周组织，显然是产生所需回压的有效方法。——通常在一个或两个表面都能获得强大的回压。——如果首次牙周韧带注射失败，再次注射通常会成功。——使用手枪式压力注射器实现麻醉的总体成功率为83%。这是将需要再次注射的情况包括在内后确定的。——将本研究结果与之前的一项类似研究进行比较，压力注射器在补充麻醉方面同样有效。
