Influence of needle bevel design on injection pain and needle deformation in dental local infiltration anaesthesia – randomized clinical trial

Dau, Michael; Buttchereit, Ingo; Ganz, Cornelia; Frerich, Bernhard; Анисимова, Е. Н.; Daubländer, Monika; Kämmerer, Peer W.

doi:10.1016/j.ijom.2017.06.013

Cited by 12 publications

(8 citation statements)

References 24 publications

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“…Although vibration decreased the pain score during needle insertion and anesthetic injection in the current study, several factors can affect the severity of pain during anesthetic injection, including the type, amount, and speed of the anesthetic injection and the dental clinician's experience and expertise [45678910]. In addition to treatment-related factors, psychological variables such as fear and anxiety also affect pain severity.…”

Section: Discussionmentioning

confidence: 74%

“…Successful local anesthesia requires adequate knowledge of the ingredients of the anesthetic agents and the neuroanatomy of the region, as well as selection of an appropriate injection technique. Several methods have been suggested to decrease the level of pain experienced during needle insertion, such as applying topical anesthetic agents, ensuring the correct direction of the needle bevel, using a small-gauge needle, and administering low-level laser treatment [4567]. Furthermore, some strategies have been proposed to decrease the level of pain experienced during the injection of an anesthetic agent, such as injecting the anesthetic agent slowly and warming or buffering the anesthetic agent.…”

Section: Introductionmentioning

confidence: 99%

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Effect of vibratory stimulation on pain during local anesthesia injections: a clinical trial

et al. 2019

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Objectives: This study aimed to assess the effect of DentalVibe on the level of pain experienced during anesthetic injections using 2 different techniques. Materials and Methods: This randomized crossover clinical trial evaluated 60 patients who required 2-session endodontic treatment. Labial infiltration (LI) anesthesia was administered in the anterior maxilla of 30 patients, while inferior alveolar nerve block (IANB) was performed in the remaining 30 patients. 1.8 mL of 2% lidocaine was injected at a rate of 1 mL/min using a 27-gauge needle. DentalVibe was randomly assigned to either the first or second injection session. A visual analog scale was used to determine participants' pain level during needle insertion and the anesthetic injection. The paired t-test was applied to assess the efficacy of DentalVibe for pain reduction. Results: In LI anesthesia, the pain level was 12.0 ± 15.5 and 38.1 ± 21.0 during needle insertion and 19.1 ± 16.1 and 48.9 ± 24.6 during the anesthetic injection using DentalVibe and the conventional method, respectively. In IANB, the pain level was 14.1 ± 15.9 and 35.1 ± 20.8 during needle insertion and 17.3 ± 14.2 and 39.5 ± 20.8 during the anesthetic injection using DentalVibe and the conventional method, respectively. DentalVibe significantly decreased the level of pain experienced during needle insertion and the anesthetic injection in anterior LI and mandibular IANB anesthesia. Conclusions: The results suggest that DentalVibe can be used to reduce the level of pain experienced by adult patients during needle insertion and anesthetic injection.

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Section: Discussionmentioning

confidence: 74%

Section: Introductionmentioning

confidence: 99%

Effect of vibratory stimulation on pain during local anesthesia injections: a clinical trial

et al. 2019

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“…All needles, following at least one insertion, displayed needle tip deformation after bone contact which seems intuitive and is similar to results in another investigation where 97% of needle tips were also affected . It is worth noting, however, that in another study, bevel tip deformation did not increase following bone contact beyond what was attributed to soft tissue caused deformation . The aforementioned study used only light microscopy at 40x and 100x power which is considerably less than other SEM studies and this may help explain the inconsistency in results.…”

Section: Discussionmentioning

confidence: 85%

“…Other authors have suggested that the tearing of tissues caused by needle tip deformation (also referred to as distortion, deviation and barbing) after contacting bone during IANBs may be a significant contributory factor . Additionally, the degree of needle tip deformation may be influenced by such factors as clinician variability, force differential, bevel characteristics and manufacturing differences (). Furthermore, there appears to be no consistent agreement as to the preferred orientation of the bevel during standard IANB delivery .…”

Section: Introductionmentioning

confidence: 99%

Evaluation of bevelled needle tip deformation with Dental Inferior Alveolar Nerve blocks

2019

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The study aimed to investigate whether any correlation existed between bevel orientation and needle tip deformation following the administration of a standard inferior alveolar nerve block (IANB) technique during patient treatment. Ninety-three needles of a single brand were collected from a group of eleven similarly trained Australian dentists' following either single or dual insertion and bone contact. Specimens were examined under scanning electron microscopy at 500x, and both the direction of deformation (either towards or away from lumen) and the extent of deformation were calculated using image processing software. Results showed no correlation between bevel orientation and either the direction (P = 0.8787) or degree (P = 0.0752) of deformation. Significance was demonstrated, regardless of bevel orientation, following multiple needle use with respect to extent of needle tip deformation (P < 0.0001). A clinical recommendation can be made that the dental needle should be routinely replaced when subsequent injections are required during the delivery of a typical IANB.

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“…Mental and drug-related preparation (pre-anesthesiapremedication) do not have as a primary objective the control of intraoperative pain (covered by the anesthesia), but mainly the control of the mental reaction to pain [12,13]. The patient is first and foremost afraid of pain, pain being an experience each person encounters more or less frequently, in a higher or lower intensity.…”

mentioning

confidence: 99%

Semiology of the Pain Syndrome - Identifying the Ideal Methods of Locoregional Anesthesia Based on Their Rationale and Features

Scutariu¹,

Dănilă²,

Ciupilan³

et al. 2017

Rev. Chim.

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Anesthesia and the degree of control over the perception of pain depends on the personality of the individual, the socio-economic conditions, potential previous painful experiences and, last but not least, on fatigue and fear of the dentist. The perception of pain in patients is closely connected to their mental state. Pain is defined as a sensation of discomfort, with wide variations, both in quality and intensity, for different people in seemingly identical conditions; an unpleasant sensitive and emotional phenomena connected to the threat of a wound or caused in the tissues or described in the terms of this disease. The essential element of any type of anesthesia is analgesia, an effect which in some cases cannot be achived, due to the patient�s particularities or the physician�s lack of experience in anesthesia. Locoregional anesthesia (LRA) represents the blocking of the nociceptive sensitive and sympathetic autonomic afferents as well as that of motor efferents at the level of peripheral nerves� axons, by means of local anesthetic. To achieve the set purpose, we carried out a study on a representative human sample comprised of 10.123 patients treated in the Oral and Maxillofacial Surgery Clinic (Ambulatory) from the County Clinic Emergency Hospital St. Spiridon Iasi, between 01.01.2015-31.12.2016. The reason for the exclusion of certain categories of patients in the reseach was: the patients with a special conditions background require individual pre-anesthesia schemes, personalised for the nature of the pre-existing general condition, which must be further approved by the attending specialist physician : cardiologist, internist, diabetologist; children under 18 years old, with a high degree of anxiety; a high precentage of elderly patients, over 60 years old, possess a combination of general issues, thus requiring a special approach. The thoroughness lying at the core of the anesthetic practice, most especially the safegurading of a technical accuracy in the performance of anesthesia [12,], instead of improvisations, the lack of anatomical and stomatological training in general and the resulting inefficiency as such, is the underlying in-depth structuring element of this paper.

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Influence of needle bevel design on injection pain and needle deformation in dental local infiltration anaesthesia – randomized clinical trial

Cited by 12 publications

References 24 publications

Effect of vibratory stimulation on pain during local anesthesia injections: a clinical trial

Effect of vibratory stimulation on pain during local anesthesia injections: a clinical trial

Evaluation of bevelled needle tip deformation with Dental Inferior Alveolar Nerve blocks

Semiology of the Pain Syndrome - Identifying the Ideal Methods of Locoregional Anesthesia Based on Their Rationale and Features

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