The Effect of Cryotherapy Application on the Success Rate of Inferior Alveolar Nerve Block in Patients with Symptomatic Irreversible Pulpitis

Topçuoğlu, Hüseyin Sinan; Arslan, Hakan; Topçuoğlu, Gamze; Demirbuğa, Sezer

doi:10.1016/j.joen.2019.05.001

Cited by 19 publications

(15 citation statements)

References 28 publications

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“…Several investigators have reported positive impacts on anaesthesia success rates after placing a small pack containing ice at the buccal vestibule of teeth with irreversible pulpitis following IANB injections (Topçuoğlu et al, 2019). However, in that study, due to the nature of the cryotherapy, the patients could not be blinded (Brignardello‐Petersen, 2019).…”

Section: Cryotherapymentioning

confidence: 99%

Present status and future directions—Mechanisms and management of local anaesthetic failures

Parirokh

Abbott

2022

Int Endodontic J

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Aim: To review variables and management techniques that may affect anaesthesia failure during root canal treatment and methods of overcoming anaesthesia failure. Methodology:The PubMed and Cochran databases were searched for evidencebased investigations regarding pain during needle insertion, pain on injection, efficacy of the anaesthetic solutions and anaesthesia techniques, and premedication.Results: Variables such as pain on injection, premedication with various types of drugs, volume of anaesthetic solutions, supplemental anaesthetic techniques, and additives to the anaesthetic solutions may influence pain perception during root canal treatment. Differences between teeth with healthy pulps versus those with irreversible pulpitis should be considered when the effects of variables are interpreted.However, there are several concerns regarding the methodology of investigations that have evaluated anaesthesia success rates. Conclusion:Several variables may influence anaesthesia success rates. There are conditions that may help to predict a patient's pain during endodontic procedures. These conditions could be overcome either by employing methods such as premedication with a non-steroidal anti-inflammatory drug prior to the treatment visit or by using supplementary techniques before or during the treatment. However, investigators need to be more careful when reporting details of their studies to reduce concerns regarding their study bias.

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Section: Cryotherapymentioning

confidence: 99%

Present status and future directions—Mechanisms and management of local anaesthetic failures

Parirokh

Abbott

2022

Int Endodontic J

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“…These factors may help explain why local anaesthesia is not always effective for mandibular molars with SIP. Many methods have been investigated to IANB success, such as changing the type of anaesthetic solution (Ashraf et al, 2013), the use of different volumes of anaesthetic solution (Fowler & Reader, 2013), buffering the anaesthetic solution (Schellenberg et al, 2015), administering preoperative drugs to patients (Oleson et al, 2010), applying supportive anaesthesia techniques in addition to IANB (Aggarwal et al, 2009), acupuncture (Jalali et al, 2015) and cryotherapy (Topçuoğlu et al, 2019).…”

Section: Introductionmentioning

confidence: 99%

The effect of low‐level laser therapy on the success rate of inferior alveolar nerve blocks in mandibular molars with symptomatic irreversible pulpitis: A randomized clinical trial

Topçuoğlu

Akpınar

2021

Int Endodontic J

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Aim To evaluate the effect of low‐level laser therapy (LLLT) on the success rate of inferior alveolar nerve blocks (IANB) in mandibular molar teeth with symptomatic irreversible pulpitis (SIP). Methodology Eighty‐eight patients who were diagnosed with SIP were randomly divided into two groups: the group in which only IANB was applied and the group in which IANB + LLLT was applied. IANB was applied to patients in the control group with 4% articaine. LLLT was applied to the patients in the experimental group in addition to IANB. The pain experienced during the operation was evaluated using a visual analog scale. If the patients reported moderate or severe pain during the treatment, the IANB was defined as unsuccessful. Pearson's chi‐square test was used to analyse anaesthetic success rates. Results Whilst the anaesthesia success rate was 34% in the group where only IANB was applied, it was 57% in the group in which LLLT was applied in addition to IANB. There was a significant difference between the groups (p = .032). Conclusions The application of LLLT to support IANB in mandibular molar teeth with SIP increased the success of anaesthesia. However, it was insufficient for a complete pulpal anaesthesia.

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“…Various strategies have been used to increase the success rate of IANBs in these situations, such as using modified techniques targeting different anatomical landmarks (Khalil, 2014), changing the type and/or increasing the volume of the local anaesthetic solution (Aggarwal et al, 2012;Nagendrababu et al, 2020a;Visconti et al, 2016), using mepivacaine to overcome the TTX-resistant receptors (Brau et al, 2000), prescribing an oral premedication of NSAIDs or corticosteroids (Shahi et al, 2013), using carbonated solutions (Aulestia-Viera et al, 2018), cryotherapy (Topcuoğlu et al, 2019), low-level laser therapy (LLLT) (Topcuoğlu & Akpinar, 2021), and the administration of supplementary buccal and lingual infiltrations (BI/ LI) and/or intra-ligamentary (PDL), intra-osseous (IO) and intra-pulpal injections (Hargreaves et al, 2008;Zanjir et al, 2019). A recent systematic review with meta-analysis and trial sequential analysis concluded that 100% anaesthetic success was not achieved in teeth with SIP, and that supplemental techniques are recommended to achieve pulpal anaesthesia when IANB fails (Nagendrababu et al, 2021).…”

Section: Introductionmentioning

confidence: 99%

Efficacy of four local anaesthesia protocols for mandibular first molars with symptomatic irreversible pulpitis: A randomized clinical trial

et al. 2021

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To examine the efficacy rate of four anaesthetic protocols in mandibular first molars with symptomatic irreversible pulpitis (SIP).Methodology: One hundred and sixty patients with a diagnosis of SIP were included in this randomized clinical trial. Patients were randomly allocated into four treatment groups (N = 40) according to the administered technique: Group 1 (IANB): standard inferior alveolar nerve block (IANB) injection; Group 2 (IANB + IO): standard IANB followed by a supplemental intraosseous infusion (IO) injection; Group 3 (IANB + PDL): standard IANB followed by a supplemental periodontal ligament (PDL) injection; Group 4 (IANB + BI): standard IANB followed by a supplemental buccal infiltration. Patients rated pain intensity using a verbal rating scale when the root canal treatment procedure was initiated, that is, during caries removal, access preparation and pulpectomy. Heart rate changes were recorded before, during and after each injection. The anaesthetic efficacy rates were analysed using chi-square tests, age differences using one-way anova, gender differences using Fischer Exact tests whilst heart rate changes were analysed using Kruskal-Wallis tests. Statistical significances were set at p < .05 level. Results: All the included patients were analysed. No differences in the efficacy rate were found in relation to the age or gender of the participants amongst the study groups (p > .05). IANB + IO injections had a significantly higher efficacy rate (92.5%) when compared to other techniques (p < .05), followed by IANB + PDL injections (72.5%), IANB + BI injections (65.0%), with no significant differences between the IANB + PDL or IANB + BI injections (p > .05). IANB injection alone had a significantly lower rate (40%) compared to the other techniques (p < .05). A transient but significant rise in the heart rate was recorded in 60% (24/40) of patients who received the IANB + IO injection compared to other groups (p < .05). Conclusions:Inferior alveolar nerve block injection alone did not reliably permit pain-free treatment for mandibular molars with SIP. The use of an additional IO supplemental injection provided the most effective anaesthesia for patients requiring emergency root canal treatment for SIP in mandibular posterior teeth.

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The Effect of Cryotherapy Application on the Success Rate of Inferior Alveolar Nerve Block in Patients with Symptomatic Irreversible Pulpitis

Cited by 19 publications

References 28 publications

Present status and future directions—Mechanisms and management of local anaesthetic failures

Present status and future directions—Mechanisms and management of local anaesthetic failures

The effect of low‐level laser therapy on the success rate of inferior alveolar nerve blocks in mandibular molars with symptomatic irreversible pulpitis: A randomized clinical trial

Efficacy of four local anaesthesia protocols for mandibular first molars with symptomatic irreversible pulpitis: A randomized clinical trial

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