Is Inferior Alveolar Nerve Block Needed to Perform Implant Surgery in the Posterior Mandible? A Randomized Controlled Trial

Esteve-Pardo, G; De-Larriva, E.; Salgado, Abel; Bernabeu-Esclapez, A; Bardaji, Javier A.; Colomina, Lino Esteve

doi:10.1016/j.joms.2021.09.028

Cited by 4 publications

(2 citation statements)

References 30 publications

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“…In irreversible pulpitis, IANB failure may be experienced due to local acidosis or activation of nociceptors because of inflammation. There are studies stating that IANB may not be necessary for standard implant surgery in the posterior mandible, and infiltration anesthesia with 4% articaine 1:100.00 epinephrine may be sufficient ( 24 ). In their study, Garcia-Blanko et al ( 3 ) compared the effects of 4% articaine during both infiltrative anesthesia and mandibular anesthesia.…”

Section: Discussionmentioning

confidence: 99%

Articaine versus lidocaine inferior alveolar nerve block in posterior mandible implant surgeries: a randomized controlled trial

Gülnahar¹,

Alpan²,

Gülnahar³

2023

Med Oral

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Background The aim of this study is to compare the effects of %4 articaine and %2 lidocaine on inferior alveolar nerve block (IANB) for implant surgery in the posterior mandible. Material and Methods The patients who have inserted implants in the posterior mandible were divided into 2 groups for IANB: lidocaine and articaine. VAS = visual analog scale, pain during surgery and injection, lip numbness time, mandibular canal-implant apex distance, age, gender, bone density, implant number, release incision, adjacent teeth, and duration of surgery were analyzed using t-test, Mann-Whitney U test, Spearman's coefficient, and, Pearson's chi-squared test. This trial followed the recommendations of the Consort Statement for reporting randomized controlled trials. Results 577 patients were included and 1185 dental implants were analyzed. There was no significant difference between the two groups in terms of injection and surgery VAS values ( p >0.05). The lip numbness time of lidocaine was 3.06±3.22min while articaine was found to be 2.96±3.09min ( p >0.05). Mandibular canal-implant apex distance was found to be 2.28±0.75mm in the articaine and 2.45±0.86mm in the lidocaine group ( p <0.05). Release incision was made more in the articaine group (51/252) than in the lidocaine group (40/325) ( p <0.05). Conclusions There was no difference between the %4 articaine and %2 lidocaine in terms of pain perception in posterior mandible implant applications. Both anesthetics provided adequate anesthesia for implant application. Key words: Articaine, dental implant, lidocaine, local anesthesia, mandibular nerve, pain perception.

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Section: Discussionmentioning

confidence: 99%

Articaine versus lidocaine inferior alveolar nerve block in posterior mandible implant surgeries: a randomized controlled trial

Gülnahar¹,

Alpan²,

Gülnahar³

2023

Med Oral

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“…Conventional nerve block with inferior alveolar nerve block (IANB) using articaine with adrenaline has been reported to be effective against pain caused by drilling for implants in RCT [ 31 ], while it has also been reported to be ineffective [ 32 ]. The fact that the failure rate of conventional IANB is high [ 33 ] may be related to this discrepancy.…”

Section: Pain Control By Local Anesthesia For Implant Surgerymentioning

confidence: 99%

Considerations for Satisfactory Sedation during Dental Implant Surgery

Ito

Utsumi

Baba

et al. 2023

JPM

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Implant surgery is a lengthy dental procedure, and sedation is often used to reduce discomfort. The effectiveness of sedation has traditionally been evaluated in terms of patient and surgeon satisfaction, but the most important goal is not to induce a deep sleep in the patient, but rather to ensure that the surgery is performed safely and as planned. Additionally, adequate pain control is a necessary requirement for patient and surgeon satisfaction. Most patients undergoing implant surgery are middle-aged or older, and a relatively large number of them have cardiovascular disease. Infiltration anesthesia using articaine or lidocaine in combination with adrenaline is widely used, but its use in patients with cardiovascular disease is limited because of adrenaline’s effects on the cardiovascular system. The use of long-acting local anesthetics and the potential efficacy of ultrasound-guided jaw nerve block have been investigated to enhance analgesia without resorting to adrenaline. Midazolam and propofol are usually used for sedation, but dexmedetomidine, which causes less respiratory depression, and the ultrashort-acting benzodiazepine remimazolam are emerging as potential alternatives. Monitoring of anesthetic depth using electroencephalography is effective in maintaining a constant level of sedation. In addition, sedation promotes the stabilization of heart rate and blood pressure, reducing the risks associated with adrenaline and allowing for safer management.

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Challenge of creating an inferior alveolar nerve block device that allows for safe, secure, and successful performance by any operator: Non-clinical studies on models

Noguchi

Odaka

Fukuda

2022

Preprint

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Purpose Inferior alveolar nerve block (IANB) is a useful nerve block in dental practice, but its success rate remains limited. This is largely attributed to operator and anatomical factors. There are some dentists who do not choose IANB owing to complications. Therefore, we conducted a pilot study that aimed to create an IANB device that allows for safe, secure, and successful performance by any operator. Methods In this study, three types of IANB devices were created for a skull model as a pilot study for clinical applications. They were designed with the dentition as a fixed point, and mandibular foramen as a target point. The dentition and jawbone were converted into data using an intraoral scanner and computed tomography imaging, respectively. A device was designed from the obtained data and output using a 3D printer. We verified the production time, material usage, and accuracy, and discussed the potential for clinical applications. Results The average time required for printing was 201 minutes. The average amount of biocompatible resin and support material used was 36 g and 52.3 g, respectively. The error between the actual needle tip position of the completed device and the needle tip position at the time of design was 0.63 mm on average. Conclusion IANB device created in this study requires more time and has higher costs than conventional IANB; however, it has sufficient accuracy for clinical applications, and potential for a safe and secure IANB that can be conducted by any operator can be expected.

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Is Inferior Alveolar Nerve Block Needed to Perform Implant Surgery in the Posterior Mandible? A Randomized Controlled Trial

Cited by 4 publications

References 30 publications

Articaine versus lidocaine inferior alveolar nerve block in posterior mandible implant surgeries: a randomized controlled trial

Articaine versus lidocaine inferior alveolar nerve block in posterior mandible implant surgeries: a randomized controlled trial

Considerations for Satisfactory Sedation during Dental Implant Surgery

Challenge of creating an inferior alveolar nerve block device that allows for safe, secure, and successful performance by any operator: Non-clinical studies on models

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