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References

Haas DA, Lennon D. A 21 year retrospective study of reports of paresthesia following local anesthetic administration. J Can Dent Assoc. 1995; 61:319-330
Hillerup S, Jensen RH, Ersboll BK. Trigeminal nerve injury associated with injection of local anesthetics: needle lesion or neurotoxicity?. J Am Dent Assoc. 2011; 142:531-539
Renton T, Adey-Viscuso D, Meechan JG, Yilmaz Z. Trigeminal nerve injuries in relation to the local anaesthesia in mandibular injections. Br Dent J. 2010; 209 https://doi.org/10.1038/sj.bdj.2010.978
Malamed SF. Nerve injury caused by mandibular block analgesia. Int J Oral Maxillofac Surg. 2006; 35:876-877
Hillerup S, Jensen R. Nerve injury caused by mandibular block analgesia. Int J Oral Maxillofac Surg. 2006; 35:437-443
Renton T, Janjua H, Gallagher JE, Dalgleish M, Yilmaz Z. UK dentists' experience of iatrogenic trigeminal nerve injuries in relation to routine dental procedures: why, when and how often?. Br Dent J. 2013; 214:633-642 https://doi.org/10.1038/sj.bdj.2013.583
Shabazfar Nl, Daubländer M, Al-Nawas B, Kämmerer PW. Periodontal intraligament injection as alternative to inferior alveolar nerve block – meta-analysis of the literature from 1979 to 2012. Clin Oral Investig. 2014; 18:351-358 https://doi.org/10.1007/s00784-013-1113-1
Malamed SF, Gagnon S, Leblanc D. Articaine hydrochloride: a study of the safety of a new amide local anesthetic. J Am Dent Assoc. 2001; 132:177-185
Simon MA, Vree TB, Gielen MJ, Booij LH. Comparison of the effects and disposition kinetics of articaine and lidocaine in 20 patients undergoing intravenous regional anaesthesia during day case surgery. Pharm World Sci. 1998; 20:88-92
Meechan JG. The use of the mandibular infiltration anesthetic technique in adults. J Am Dent Assoc. 2011; 142:19S-24S
Corbett IP, Kanaa MD, Whitworth JM, Meechan JG. Articaine infiltration for anesthesia of mandibular first molars. J Endod. 2008; 34:514-518
Kanaa MD, Whitworth JM, Corbett IP, Meechan JG. Articaine and lidocaine mandibular buccal infiltration anesthesia: a prospective randomized double-blind cross-over study. J Endod. 2006; 32:296-298
Meechan JG, Jaber AA, Corbett IP, Whitworth JM. Buccal versus lingual articaine infiltration for mandibular tooth anaesthesia: a randomized controlled trial. Int Endod J. 2011; 44:676-681
Smith T, Urquiola R, Oueis H, Stenger J. Comparison of articaine and lidocaine in the pediatric population. J Mich Dent Assoc. 2014; 96:34-37
Lima JL, Dias-Ribeiro E, Ferreira-Rocha J, Soares R, Costa FWG, Fan S, Sant'ana E. Comparison of buccal infiltration of 4% articaine with 1:100,000 and 1:200,000 epinephrine for extraction of maxillary third molars with pericoronitis: a pilot study. Anesth Prog. 2013; 60:42-45
Darawade DA1, Kumar S2, Budhiraja S2, Mittal M3, Mehta TN4. A clinical study of efficacy of 4% articaine hydrochloride versus 2% lignocaine hydrochloride in dentistry. J Int Oral Health. 2014; 6:81-83
Thakare A1, Bhate K1, Kathariya R2. Comparison of 4% articaine and 0.5% bupivacaine anesthetic efficacy in orthodontic extractions: prospective, randomized crossover study. Acta Anaesthesiol Taiwan. 2014; 52:59-63 https://doi.org/10.1016/j.aat.2014.04.006
Monteiro MR1, Groppo FC, Haiter-Neto F, Volpato MC, Almeida JF. 4% articaine buccal infiltration versus 2% lidocaine inferior alveolar nerve block for emergency root canal treatment in mandibular molars with irreversible pulpits: a randomized clinical study. Int Endod J. 2014;
Trullenque-Eriksson A1, Guisado-Moya B. Comparative study of two local anesthetics in the surgical extraction of mandibular third molars: bupivacaine and articaine. Med Oral Patol Oral Cir Bucal. 2011; 16:e390-e396
Gregorio LV1, Giglio FP, Sakai VT, Modena KC, Colombini BL, Calvo AM A comparison of the clinical anesthetic efficacy of 4% articaine and 0.5% bupivacaine (both with 1:200,000 epinephrine) for lower third molar removal. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2008; 106:19-28
Keetley A, Moles DR. A clinical audit into the success rate of inferior alveolar nerve block analgesia in general dental practice. Prim Dent Care. 2001; 8:139-142
Wright EF. Medial pterygoid trismus (myospasm) following inferior alveolar nerve block: case report and literature review. Gen Dent. 2011; 1:64-67
El-Kholey KE. Infiltration anesthesia for extraction of the mandibular molars. J Oral Maxillofac Surg. 2013; 71:1658.e1-e5
Benson BW1, Prihoda TJ, Glass BJ. Variations in adult cortical bone mass as measured by a panoramic mandibular index. Oral Surg Oral Med Oral Pathol. 1991; 71:349-356

Articaine-only buccal infiltrations for mandibular molar extractions: an alternative to inferior dental nerve blocks

From Volume 44, Issue 9, October 2017 | Pages 838-845

Authors

Danyal H Awal

BDS BSc(Hons)

Senior House Officer, King's College Hospital, London, UK

Articles by Danyal H Awal

Zehra Yilmaz

BSc(Hons), MSc, PhD

Research Affiliate, King's College Hospital, London, UK

Articles by Zehra Yilmaz

Samira Osailan

BDS, MSc, FDS RCSeng, PhD

Consultant Oral Surgeon, King's College Hospital, London, UK

Articles by Samira Osailan

Tara Renton

BDS, MDSc, PhD

Professor of Oral Surgery, King's College London; Honorary Consultant in Oral Surgery, King's College Hospital NHS Foundation Trust and Guy's and St Thomas' NHS Foundation Trust, London

Articles by Tara Renton

Abstract

This article assesses the efficacy of the articaine-only buccal infiltration technique (AOBIT) in providing LA for adult mandibular molar extractions. In 112 patients the AOBIT effectiveness was judged against the need for repeat or supplemental infiltrations and rescue 2% lidocaine inferior dental blocks (IDBs). Sufficient anaesthesia was achieved in 57% of patients using the AOBIT, with another 27% requiring an additional dose via the AOBIT. The remaining 16% required a rescue 2% lidocaine IDB. The AOBIT could be a suitable alternative to 2% lidocaine IDBs for routine adult mandibular molar extractions, and may subsequently reduce the incidence of LA-related nerve injury.

CPD/Clinical Relevance: Debilitating nerve injury in relation to the administration of IDBs may be more common than we think. This article assesses the articaine-only buccal infiltration technique (AOBIT) as an alternative in providing local anaesthesia for routine adult mandibular molar extractions.

Article

Nerve injuries related to the administration of local anaesthesia (LA) can leave patients with lifelong neuropathic pain and may occur more frequently than we think.1,2 Inferior dental blocks (IDB) and other nerve blocks are routinely used to anaesthetize mandibular molar teeth in the UK and are often associated with an increased risk of nerve damage when compared with infiltrative techniques.3,4,5 IDBs have up to a 1 in 14,000 risk of temporary or permanent inferior dental nerve injury and this rate indicates a higher incidence of motor or sensory neuropathy when compared with spinal and epidural blocks.6 It must be mentioned that a majority of neuropraxic injuries tend to be temporary in nature, however, those that go on to be permanent tend to be life-changing.

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