Nusstein J, Reader A, Nist R, Beck M, Meyers W J
Division of Endodontics, Ohio State University, College of Dentistry, Columbus 43210, USA.
J Endod. 1998 Jul;24(7):487-91. doi: 10.1016/S0099-2399(98)80053-8.
The purpose of this study was to determine the anesthetic efficacy of a supplemental intraosseous injection of 2% lidocaine with 1:100,000 epinephrine in teeth diagnosed with irreversible pulpitis. Fifty-one patients with symptomatic, vital maxillary, and mandibular posterior teeth diagnosed with irreversible pulpitis received conventional infiltrations or inferior alveolar nerve blocks. Pulp testing was used to determine pulpal anesthesia after "clinically successful" injections. Patients who were positive to the pulp tests, or were negative to the pulp tests but felt pain during endodontic access, received an intraosseous injection using 1.8 ml of 2% lidocaine with 1:100,000 epinephrine. The results demonstrated that 42% of the patients who tested negative to the pulp tests reported pain during treatment and required supplemental anesthesia. Eighty-one percent of the mandibular teeth and 12% of maxillary teeth required an intraosseous injection due to failure to gain pulpal anesthesia. Overall, the Stabident intraosseous injection was found to be 88% successful in gaining total pulpal anesthesia for endodontic therapy. We concluded that, for posterior teeth diagnosed with irreversible pulpitis, the supplemental intraosseous injection of 2% lidocaine (1:100,000 epinephrine) was successful when conventional techniques failed.
本研究的目的是确定在诊断为不可逆性牙髓炎的牙齿中，补充骨内注射2%利多卡因加1:100,000肾上腺素的麻醉效果。51例诊断为不可逆性牙髓炎的有症状、活髓的上颌和下颌后牙患者接受了传统浸润麻醉或下牙槽神经阻滞麻醉。在“临床成功”注射后，使用牙髓测试来确定牙髓麻醉情况。牙髓测试呈阳性的患者，或牙髓测试呈阴性但在根管治疗时感到疼痛的患者，接受了1.8毫升2%利多卡因加1:100,000肾上腺素的骨内注射。结果表明，42%牙髓测试呈阴性的患者在治疗期间报告疼痛并需要补充麻醉。由于未能获得牙髓麻醉，81%的下颌牙和12%的上颌牙需要进行骨内注射。总体而言，发现Stabident骨内注射在获得根管治疗的完全牙髓麻醉方面成功率为88%。我们得出结论，对于诊断为不可逆性牙髓炎的后牙，当传统技术失败时，补充骨内注射2%利多卡因（1:100,000肾上腺素）是成功的。
