Postanesthetic Cold Sensibility Test as an Indicator for the Efficacy of Inferior Alveolar Nerve Block in Patients with Symptomatic Irreversible Pulpitis of Mandibular Molars

Sayed, Mohamed El; Gaballah, Kamis

doi:10.1155/2021/9913221

Cited by 5 publications

(6 citation statements)

References 54 publications

(123 reference statements)

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“…Assessment of pulpal status can be a perplexing task for GDPs. Thus, a number of tests are always needed to assure an accurate endodontic diagnosis [ 34 , 35 ]. Dental pulp tests, like cold tests, and the electronic pulp test (EPT), have been frequently applied to assist in endodontic diagnosis [ 35 ].…”

Section: Discussionmentioning

confidence: 99%

Assessment of the Current Endodontic Practices among General Dental Practitioners in the Kingdom of Saudi Arabia

Jouhar

Ahmed

Almomen

et al. 2022

IJERPH

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A contemporary knowledge of root canal treatment (RCT) is a prerequisite for a successful outcome. Studies observed that General Dental Practitioners (GDPs) were not abreast of current endodontic knowledge due to a lack of continuing dental education, not following the treatment protocols that they had learned in their undergraduate program, and overlooking the evidence-based current endodontic practices. Therefore, this study was intended to assess the awareness, attitude, and clinical endodontic practices among General Dental Practitioners in Saudi Arabia. This cross-sectional questionnaire-based study was conducted among all 312 GDPs working in Saudi Arabia. The questionnaire consisted of socio-demographic details and 23 questions regarding current endodontic practices. The collected data was analyzed using the SPSS Version 21 (Chicago, IL, USA). The chi-square test was applied to explore the influence of gender, workplace, and the years of professional activity on the materials and techniques employed in the RCT procedure. The study results showed that of all respondents, 159(51.0%) were males, 153(49.0%) were females, and 286(91.7%) were Saudi nationals. Most of the GDPs, i.e., 204(65.4%) practiced in private hospitals or clinics whereas 108(34.6%) practiced in Government hospitals. Root canal treatment on all teeth had been performed by 196(62%) of the practitioners. Association of gender with demographic details and endodontic practices revealed a statistically significant difference between both genders with respect to region, nationality, type of RCT treated on the tooth, and the technique used to measure the working length (p < 0.05). Furthermore, years of professional experience and workplace significantly affect endodontic practices (p < 0.05). This study concluded that most of the general dental practitioners complied with quality standard guidelines showing a positive attitude toward endodontic practices. Furthermore, irrespective of gender, most of the steps in endodontic procedures revealed a significant association with years of professional experience and the workplace.

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Section: Discussionmentioning

confidence: 99%

Assessment of the Current Endodontic Practices among General Dental Practitioners in the Kingdom of Saudi Arabia

Jouhar

Ahmed

Almomen

et al. 2022

IJERPH

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“…The primary goal of local anaesthesia is to perform painless endodontic procedures to reduce the patient's stress and increase his confidence. Several tests can be used for checking local anaesthesia attainment before initiating endodontic treatment including subjective soft tissue signs (soft tissue/lip numbness) and pulp sensibility testing via thermal and electric tests (Chavarría‐Bolaños et al, 2017; El Sayed & Gaballah, 2021; Hsiao‐Wu et al, 2007); such assessment can be challenging particularly with SIP (Allegretti et al, 2016; El Sayed & Gaballah, 2021; Virdee et al, 2015). There seems to be lack of correlation between the responses of some tests (e.g.…”

Section: Discussionmentioning

confidence: 99%

“…soft tissue/lip numbness) and pulpal anaesthesia and controversy regarding the accuracy of other tests (e.g. thermal testing) used to check anaesthetic success before initiation of treatment (Chavarría‐Bolaños et al, 2017; El Sayed & Gaballah, 2021; Hsiao‐Wu et al, 2007; Weitz et al, 2021). In this study, soft‐tissue signs (lip numbness) only were used to check for missed IANBs (Fowler et al, 2015).…”

Section: Discussionmentioning

confidence: 99%

“…and pulp sensibility testing via thermal and electric tests (Chavarría-Bolaños et al, 2017;El Sayed & Gaballah, 2021;Hsiao-Wu et al, 2007); such assessment can be challenging particularly with SIP (Allegretti et al, 2016;El Sayed & Gaballah, 2021;Virdee et al, 2015). There seems to be lack of correlation between the responses of some tests (e.g.…”

Section: Discussionmentioning

confidence: 99%

“…In this study, soft-tissue signs (lip numbness) only were used to check for missed IANBs (Fowler et al, 2015). Due to the multifaceted aspects of pain experience, various tools have been developed for its measurement; several of such tools have been used to assess intraoperative pain including visual analogue scale (VAS), Heft-Parker-VAS, Verbal Rating Scale (VRS) and Numerical Rating Scale (NRS) (El Sayed & Gaballah, 2021;Larocca de Geus et al, 2020;Zanjir et al, 2019). In this study, an 11-point NRS was used as it is easier to use than visual analogue scales (VASs) and more sensitive than Verbal Rating Scales (VRSs) (Hjermstad et al, 2011).…”

Section: Discussionmentioning

confidence: 99%

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Inferior alveolar nerve block success of 2% mepivacaine versus 4% articaine in patients with symptomatic irreversible pulpitis in mandibular molars: A randomized double‐blind single‐centre clinical trial

et al. 2022

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Aim The aim of this study was to assess inferior alveolar nerve block (IANB) success of 2% mepivacaine (Scandonest 2%, Septodont, France) and 4% articaine (Septanest 4%, Septodont) in patients with symptomatic irreversible pulpitis (SIP) in mandibular molars during access cavity preparation and instrumentation. Methodology Three hundred and thirty patients with moderate‐to‐severe pain in mandibular molars with SIP randomly received either 3.6 ml 2% mepivacaine hydrochloride with 1:100 000 adrenalin or 3.4 ml 4% articaine hydrochloride with 1:100 000 adrenalin (n = 165). Intraoperative pain (IOP) intensity was assessed during access cavity preparation and canal instrumentation using 11‐point Numerical Rating Scale (NRS). Overall success was considered if the patient felt no‐to‐mild pain without the need for supplemental anaesthesia throughout treatment; the incidence of need for supplemental anaesthesia was also recorded. Data were statistically analysed using Mann–Whitney U‐ and Chi‐squared (χ2) tests. Relative risk (RR) and 95% confidence interval (CI) of anaesthetic failure were calculated. The effect of pre‐disposing factors on outcome variables was assessed using multivariable regression analyses. None of the participants reported any adverse effects. Results Baseline variables were balanced between groups (p > .05). The IOP intensity during access cavity preparation and canal instrumentation was similar for both groups (p > .05). IOP intensity was associated with preoperative pain intensity and tooth type (p < .05). Overall anaesthetic success rate was 35.8% for mepivacaine and 41.2% for articaine (p > .05) with a relative risk of failure [95% CI] 1.09 [0.92, 1.30]. The need for supplemental anaesthesia occurred 43.6% and 38.2% with mepivacaine and articaine respectively (p > .05; RR [95% CI]: 1.14 [0.88, 1.48]). Preoperative pain level and age were associated with the need for supplemental anaesthesia. Conclusions 2% mepivacaine and 4% articaine demonstrate similar IANB success rates for mandibular molars with SIP. Intraoperative pain experience during endodontic treatment can be associated with preoperative pain, tooth type and age.

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Cryotherapy and pain intensity during endodontic treatment of mandibular first permanent molars with symptomatic irreversible pulpitis: A randomized controlled trial

Elheeny,

Sermani,

Saliab

et al. 2023

Clin Oral Invest

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Objectives The study aimed to assess the effectiveness of cryotherapy application after inferior alveolar nerve block (IANB) administration of the mandibular first permanent molars with symptomatic irreversible pulpitis (SIP) in adolescence. The secondary outcome was to compare the need for supplemental intraligamentary injection (ILI). Materials and methods The study was designed as a randomized clinical trial including 152 participants aged from 10 to 17 years who were randomly assigned to two equal groups; cryotherapy plus IANB (intervention group) and the control group (conventional INAB). Both groups received 3.6 mL of 4% articaine. For the intervention group, ice packs were applied in the buccal vestibule of the mandibular first permanent molar for 5 min. Endodontic procedures started after 20 min for efficiently anesthetized teeth. The intraoperative pain intensity was measured using the visual analogue scale (VAS). The Mann–Whitney (U) and chi-square tests were applied to analyze data. The significance level was set to 0.05. Results There was a significant reduction in the overall intraoperative VAS mean in the cryotherapy group compared to that in the control group (p = 0.004). The success rate was significantly higher in the cryotherapy group (59.2%) compared to the control group (40.8%). The frequency of extra ILI was 50% and 67.1% in the cryotherapy and control groups, respectively (p = 0.032). Conclusions The cryotherapy application boosted the efficacy of pulpal anesthesia of the mandibular first permanent molars with SIP in patients below the age of 18 years. Additional anesthesia was still necessary for optimal control over pain. Clinical relevance Pain control during endodontic treatment of primary molars with irreversible pulpitis (IP) is a significant factor in a child’s behavior in the dental office. Although the inferior alveolar nerve block (IANB) is the most commonly used technique to anaesthetize mandibular dentition, we found its success rate to be relatively low during endodontic treatment of primary molars with IP. Cryotherapy is a new approach that significantly improves the efficacy of IANB. Clinical trial registration The trial was registered at ClinicalTrials.gov (reference no. NCT05267847).

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Postanesthetic Cold Sensibility Test as an Indicator for the Efficacy of Inferior Alveolar Nerve Block in Patients with Symptomatic Irreversible Pulpitis of Mandibular Molars

Cited by 5 publications

References 54 publications

Assessment of the Current Endodontic Practices among General Dental Practitioners in the Kingdom of Saudi Arabia

Assessment of the Current Endodontic Practices among General Dental Practitioners in the Kingdom of Saudi Arabia

Inferior alveolar nerve block success of 2% mepivacaine versus 4% articaine in patients with symptomatic irreversible pulpitis in mandibular molars: A randomized double‐blind single‐centre clinical trial

Cryotherapy and pain intensity during endodontic treatment of mandibular first permanent molars with symptomatic irreversible pulpitis: A randomized controlled trial

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