Effect of Sodium Bicarbonate Buccal Infiltration on the Success of Inferior Alveolar Nerve Block in Mandibular First Molars with Symptomatic Irreversible Pulpitis: A Prospective, Randomized Double-blind Study

Saatchi, Masoud; Shenasa, Naghmeh; Haghighi, Saeideh Karimi

doi:10.1016/j.joen.2016.07.004

Cited by 21 publications

(21 citation statements)

References 33 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Previous investigations on buffering of anaesthetic solutions used the buffering agent simultaneously with the anaesthetic solutions. However, when the buffering agent was used in combination with 2% lignocaine administrated via infiltration injection 15 min prior to an IANB injection, a significantly higher rate of anaesthetic success was achieved in mandibular first molars with acute irreversible pulpitis . The addition of sodium bicarbonate to buffer the acidic nature of 2% lignocaine did not reduce the pain of injection, and it did not reduce the onset of anaesthesia when used as a maxillary infiltration injection .…”

Section: Intra‐operative Strategiesmentioning

confidence: 95%

Strategies for managing pain during endodontic treatment

Abbott

Parirokh

2018

Aust Endodontic J

View full text Add to dashboard Cite

Many patients associate root canal treatment with pain. Unfortunately, local anaesthetic techniques such as infiltrations and inferior alveolar nerve blocks are not very effective as single injections for acute irreversible pulpitis. This review discusses strategies for more effective pain management for such situations. Pain control before, during and after treatment is essential for effective patient management. Adequate pain control during treatment also reduces post-operative pain. Effective pain management begins with a thorough understanding of the conditions being treated and an accurate diagnosis. In some cases, premedication with non-steroidal anti-inflammatory drugs can help reduce intra-operative pain. Pain management during treatment involves standard local anaesthetic solutions and injection techniques plus increased volumes and supplementary injections. Once anaesthesia is achieved, treatment can be commenced and the root canal system can be medicated to relieve pain. These should be followed by flexible post-operative pain management strategies for the individual patient and specific condition.

show abstract

Section: Intra‐operative Strategiesmentioning

confidence: 95%

Strategies for managing pain during endodontic treatment

Abbott

Parirokh

2018

Aust Endodontic J

View full text Add to dashboard Cite

show abstract

“…Shyamala et al (2016) indicated that the anaesthetic duration remains unchanged when the LA is buffered; conversely, Brennan et al (1987) affirmed that the duration is diminished. However, Saatchi et al (2016) reported that a buccal infiltration of sodium bicarbonate increased the success rate of inferior alveolar nerve block in the presence of pulpitis. However, Saatchi et al (2016) reported that a buccal infiltration of sodium bicarbonate increased the success rate of inferior alveolar nerve block in the presence of pulpitis.…”

Section: Discussionmentioning

confidence: 99%

“…Rood (1977), Parirokh (2016), Saatchi et al (2015) and Schellenberg et al (2015) observed that alkalinization did not increase the anaesthetic success in the presence of acute inflammation, and Shurtz et al (2015) and Whitcomb et al (2010) did not find a significant benefit in normal tissues either. However, Saatchi et al (2016) reported that a buccal infiltration of sodium bicarbonate increased the success rate of inferior alveolar nerve block in the presence of pulpitis.…”

Section: Discussionmentioning

confidence: 99%

“…One explanation for this uncomfortable sensation is the acidic nature of commercially available local anaesthetics (pH 4.5, approximately), which are adjusted to this pH to prolong shelf life (Hogan et al 2011, Malamed et al 2013, Harreld et al 2015, Schellenberg et al 2015, Shurtz et al 2015. As the physiological pH is about 7.4, an increase in H + in the tissues could cause pain by activating nociceptors such as the acid-sensing ion channels (ASICs) (Cepeda et al 2010, Saatchi et al 2016. Conversely, for the anaesthetic to penetrate the nerve sheath, it must be in its unionized free base form; then, the H + ion needs to dissociate from the ionized molecule (Kumar et al 2015).…”

Section: Introductionmentioning

confidence: 99%

“…Conversely, for the anaesthetic to penetrate the nerve sheath, it must be in its unionized free base form; then, the H + ion needs to dissociate from the ionized molecule (Kumar et al 2015). As the physiological pH is about 7.4, an increase in H + in the tissues could cause pain by activating nociceptors such as the acid-sensing ion channels (ASICs) (Cepeda et al 2010, Saatchi et al 2016. Buffering the local anaesthetic solution could produce less pain because fewer acid-sensing nociceptors would be activated.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

The effect of adjusting the pH of local anaesthetics in dentistry: a systematic review and meta‐analysis

2018

View full text Add to dashboard Cite

The acidic nature of commercial local anaesthetics (LAs) can cause pain during infiltration and delay the onset of anaesthesia. It is suggested that adjusting the pH of anaesthetic agents could minimize these effects. This systematic review aimed to evaluate the efficacy of buffered LAs in reducing infiltration pain and onset time during dental procedures. MEDLINE, Embase, Scopus and Scielo databases were searched up to April 2017. Randomized controlled trials comparing buffered and unbuffered LAs for intraoral injections were included. Risk of bias was assessed using the Cochrane Collaboration tool. Data upon injection pain and onset time were pooled in a random-effects model. Subgroup analyses compared normal and inflamed tissues, and terminal infiltrations and inferior alveolar nerve (IAN) blocks. Meta-regressions were performed to explain heterogeneity. Fourteen articles were included in this review. Lidocaine with epinephrine was the most used anaesthetic combination. Nonlidocaine studies (n = 2) were not pooled in the meta-analysis. Buffered lidocaine did not result in less pain during intraoral injections: mean difference -6.4 (95% CI -12.81 to 0.01) units in a 0-100 scale. Alkalinized lidocaine did not reduce the onset time in normal tissues when terminal infiltration techniques were used, but resulted in a more rapid onset for IAN blocks (-1.26 min) and in inflamed tissues (-1.37 min); however, this change may not be clinically relevant, considering the time required to prepare the buffered agent. Studies performed using other anaesthetic salts did not show robust and clinically significant results in favour of alkalinization.

show abstract

Local Anesthetics

Jeske

2024

Contemporary Dental Pharmacology

View full text Add to dashboard Cite

Effect of Sodium Bicarbonate Buccal Infiltration on the Success of Inferior Alveolar Nerve Block in Mandibular First Molars with Symptomatic Irreversible Pulpitis: A Prospective, Randomized Double-blind Study

Cited by 21 publications

References 33 publications

Strategies for managing pain during endodontic treatment

Strategies for managing pain during endodontic treatment

The effect of adjusting the pH of local anaesthetics in dentistry: a systematic review and meta‐analysis

Local Anesthetics

Contact Info

Product

Resources

About