Which is the most suitable local anaesthetic when inferior nerve blocks are used for impacted mandibular third molar extraction? A network meta-analysis

Camps‐Font, Octavi; Figueiredo, Rui; Sánchez‐Torres, Alba; Clé-Ovejero, Adrià; Coulthard, Paul; Gay‐Escoda, Cosme; Valmaseda‐Castellón, Eduard

doi:10.1016/j.ijom.2020.04.016

Cited by 13 publications

(10 citation statements)

References 58 publications

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“…For this reason, it is necessary to use an additional, so-called freezing anesthesia, which will improve the anesthetic effectiveness of local anesthetics administered by injection. The emergence of some new methods of administration of painkillers not only replaced the traditional ones, but also significantly increased the effectiveness of anesthesia [11].…”

Section: Discussionmentioning

confidence: 99%

Effective Anesthesia during Various Manipulations in Maxillofacial Surgery and in Dental Practice: Overview of Medicines

Davtyan

Khamarova

Марков

et al. 2021

JPRI

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In the practice of modern specialists of maxillofacial surgery and dentists, the use of local anesthetics is a necessary condition for comfortable medical manipulations. Accordingly, in order to achieve the medical goals, it is necessary to make a competent choice of anesthetic medicines. Most often, drugs that are used contain amides, the method of administration of which is blocking or infiltration anesthesia. The specialist should take into account that not all patients will always have the same effective response to a particular local anesthetic, for this reason, it is necessary to constantly update information about modern local anesthetics in order to apply them in medical practice. The aim of the work is to review the medicines used for local anesthesia both in the practice of dentists and maxillofacial surgeons when providing care for the patients over the age of 18.

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Section: Discussionmentioning

confidence: 99%

Effective Anesthesia during Various Manipulations in Maxillofacial Surgery and in Dental Practice: Overview of Medicines

Davtyan

Khamarova

Марков

et al. 2021

JPRI

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“…However, articaine still had its downside of prolonged soft tissue anesthesia (paresthesia) reported after the conclusion of the procedure [5,53], making them more susceptible to selfinjury in addition to be more annoying to the patient to the point that requires ansethetic reversal in some situations [54][55][56]. Besides, lidocaine has shown to have a wider margin of safety than articaine according to a recent meta-analysis study [10].…”

Section: Discussionmentioning

confidence: 99%

“…Many modifications have therefore been implemented to increase these success rates and make them more predictable. Such modifications include changing the type of anesthetic solution [9,10], its injected volume [11], composition e.g. buffering / twin mixing [12][13][14], combination with other supplemental anesthetic techniques [15,16], changing patients' position during injection [17], preceding the injection with oral premedication e.g.…”

Section: Introductionmentioning

confidence: 99%

The success of using 2% lidocaine in pain removal during extraction of mandibular premolars: a prospective clinical study

2020

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Background: The purpose of this study was to evaluate the anesthetic effectiveness of a buccal infiltration technique combined with local massage (using 2% lidocaine) in the extraction of mandibular premolars to be utilized as an alternative to the conventional inferior alveolar nerve block. Methods: Patients eligible included any subject with a clinical indication for tooth extraction of the mandibular 1st or 2nd premolars. All patients were anesthetized buccally by local infiltration technique followed by an external pressure applied for 1 min directly over the injection area. In each case, another local injection was given lingually. All operations were started at approximately 5 min after the buccal injection. The collected data included age, gender, pain perception and its intensity during treatment at three checkpoints, apical tenderness, and the type of extraction. Any associated complications or difficulties were also recorded. Then the results were analyzed and interpreted using appropriate statistical tests. The significance level was set at P ≤ 0.05. Results: A total of 247 cases (1st premolar, n = 119; 2nd premolar, n = 128), predominantly male, were included. In 95% of study sample, the patients were satisfied with the dental extraction without any pain. However, in 5% of cases, pain was reported at the stage of tooth removal. Apical tenderness was found to be present in 11% of the total cases. Three teeth required surgical removal. Upon analysis, no significant differences in the success rates were detected between the 2 premolar groups or amongst the various age groups. Minor and transient side effects were reported in this study. Conclusion: The technique is simple and effective as well. It might be considered as an alternative anesthetic injection to the inferior alveolar nerve block for dental extraction of the mandibular premolars.

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“…All anaesthetic techniques used produce total or partial loss of soft tissue sensitivity for 3 to 5 h [1][2][3][4], which is often longer than the working time plus the time needed for pain control after a restorative or periodontal procedure [5,6]. This duration is most often associated with difficulty in eating, drinking, speaking and smiling [7][8][9][10][11], and can cause biting injuries to the lips, tongue and cheeks, particularly in children and disabled people [12,13].…”

Section: Introductionmentioning

confidence: 99%

Use of Phentolamine Mesylate in Implant Surgery: Analysis of Adverse Effects and Haemodynamic Changes

Vintanel-Moreno

Martı́nez-González

Martínez-Rodríguez

et al. 2021

JCM

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The clinical application of phentolamine mesylate (PM) as an anaesthetic reversal agent has been documented in the paediatric population and in conservative dentistry, but no studies have been conducted regarding dental implant surgery. A prospective randomised study was conducted on 60 patients eligible for mandibular implant treatment, randomly divided between a control group (CG) and an experimental group (EG), to whom PM was administered. Haemodynamic changes, adverse effects and patient satisfaction were assessed. No statistically significant differences in haemodynamic changes and postoperative pain were found between CG and EG (p < 0.05), except for systolic blood pressure (SBP), which increased slightly in EG, without posing a risk to patients. There were no differences in the occurrence of adverse effects between the two groups, except for greater difficulty in chewing and biting (p < 0.05) in CG and greater pain in the injection area (p = 0.043) in EG. Among EG patients, 83.3% reported that they would request PM again for future dental treatment. The use of PM offers an alternative to implant surgery, thereby increasing patients’ quality of life without increasing the risks.

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Which is the most suitable local anaesthetic when inferior nerve blocks are used for impacted mandibular third molar extraction? A network meta-analysis

Cited by 13 publications

References 58 publications

Effective Anesthesia during Various Manipulations in Maxillofacial Surgery and in Dental Practice: Overview of Medicines

Effective Anesthesia during Various Manipulations in Maxillofacial Surgery and in Dental Practice: Overview of Medicines

The success of using 2% lidocaine in pain removal during extraction of mandibular premolars: a prospective clinical study

Use of Phentolamine Mesylate in Implant Surgery: Analysis of Adverse Effects and Haemodynamic Changes

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