Walton R E, Abbott B J
J Am Dent Assoc. 1981 Oct;103(4):571-5. doi: 10.14219/jada.archive.1981.0307.
Attaining profound local anesthesia is frequently difficult. Standard block or infiltration injections often are not sufficient; a supplementary injection is often necessary. The purpose of this study was to examine the effectiveness of the periodontal ligament injection in patients who did not have adequate pulpal anesthesia. Information was obtained by questionnaire after 120 periodontal ligament injections. The frequency and rapidity of onset of anesthesia was determined as well as the factors that might affect the technique. The following conclusions were obtained from this study. -Mandibular molars required supplementary anesthesia more frequently than other types of teeth. -Injecting under strong backpressure was important; the greatest frequency of success was attained when injecting under pressure. Injecting without strong pressure on both mesial and distal surfaces resulted in the lowest frequency of anesthesia. -Onset of anesthesia was generally very rapid, usually immediate. -The length and gauge of needle were unimportant in attaining anesthesia. -Rejection was frequently successful if the first periodontal ligament injection failed. -The overall frequency of success in attaining anesthesia with this injection was 92%. This rate included situations in which the injection was administered more than once. -The most critical factor was to inject under strong resistance. This necessitates wedging the finger supported needle into the interproximal space between root surface and bone and applying maximum pressure to the syringe handle.
实现深度局部麻醉往往很困难。标准的阻滞或浸润注射通常并不充分；常常需要进行补充注射。本研究的目的是检验牙周膜注射对牙髓麻醉不足患者的有效性。在进行120次牙周膜注射后，通过问卷调查获取信息。确定了麻醉起效的频率和速度以及可能影响该技术的因素。从本研究中得出了以下结论。——下颌磨牙比其他类型的牙齿更频繁地需要补充麻醉。——在强大的反压力下注射很重要；在压力下注射时成功率最高。在近中和远中表面均无强大压力的情况下注射，麻醉频率最低。——麻醉起效通常非常迅速，通常是即刻起效。——针的长度和规格在实现麻醉方面并不重要。——如果首次牙周膜注射失败，再次注射常常成功。——使用这种注射实现麻醉的总体成功率为92%。该比率包括多次注射的情况。——最关键的因素是在强大阻力下注射。这需要将手指支撑的针楔入牙根表面与骨之间的邻间隙，并对注射器手柄施加最大压力。
