Background and aim:The mental-incisive nerve block can be used where lower premolars and anterior teeth require treatment. The aim of this study is to compare tow methods ofmental-incisive nerve block for extraction of the lower premolars and anterior teeth.
Methods and materials:This randomized double blind split-mouth clinical trial study was performed on patients requiring extraction of lower premolars and anterior teeth bilaterally. Patients were divided into two groups (case and controls). On one side injection was administered distal to the second premolar while on the other side the injection was done between premolars. The teeth were matched in terms of clinical and radiographic features.Result: 40 patients (80 samples) with a mean age of 50.6 ± 12.7 were studied. According to the results, we had a 95% success rate with injection distal to the second premolar, but the success rate was 72.5% when the injection was done between premolars.
Conclusion:The mental-incisive nerve block with injection done distal to the second premolar was more successful than between premolars.
There is an important point related to temporomandibular joint (TMJ) injuries and derangement due to trauma from dental extractions by dental students. This subject should be an utmost cause for concern for dentists and dental practitioners. Because if not treated it may become chronic. This issue has been noted by many researchers in academic dental training centers worldwide. The results of many studies in this field have shown surprisingly high prevalence rates of TMJ injuries (50-63 %) after extracting mandibular teeth by dental students (1). About 60 % of patients develop pain, clicking and limitation of mouth opening after extraction of molar teeth (2, 3). At the Azad University Dental School (Oral and Maxillofacial Surgery Department) a similar study was done. The result was similar to those of other centers. Excessive uncontrolled force used to extract mandibular molars is one of the major factors predisposing to the development of temporomandibular disorders (TMD). Therefore, continued research in this field is warranted to increase awareness of this issue and to implement procedures to prevent TMD such as shortening procedure time for the patient, less than maximum mouth opening of the patient undergoing tooth extraction, use of controlled force by the student when extracting as well as providing manual support of the mandible upon extraction of mandibular teeth especially molars. The relationship between jaw injury, third molar removal, and orthodontic treatment and TMD symptoms in university students in Japan. J Orofac Pain. 2008;22(1):50-6. 3. Huang GJ, Rue TC. Third-molar extraction as a risk factor for temporomandibular disorder.
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