J Dent Anesth Pain Med.  2018 Apr;18(2):89-95. 10.17245/jdapm.2018.18.2.89.

Structural damage to periodontal tissues at varying rate of anesthetic injection

• Sarapultseva M
• Sarapultsev A
• Medvedeva
• Danilova I

• KMID: 2410141
• DOI: http://doi.org/10.17245/jdapm.2018.18.2.89

Abstract

BACKGROUND
Incorrect administration of an anesthetic during local anesthesia is one of the most important causes of pain symptoms in patients scheduled for dental procedures. The current study assessed the severity of damage to periodontal tissue following different rates of anesthetic administration.
METHODS
The research was conducted on 50 outbred male rats with a body mass of 180-240 g. The anesthetic used was 1% articaine.
RESULTS
The results showed that administration of the anesthetic at a rapid pace caused structural damage to the periodontal tissue. Further, signs of impaired microcirculation were noted at all rates of administration. Biochemical studies demonstrated changes in the level of glucose and enzymes with the rapid introduction of the anesthetic, indicating severe systemic stress response of the body.
CONCLUSIONS
Injection of local anesthetic at any rate of introduction induces vascular congestion in the microcirculatory bloodstream and exudative reactions. Rapid introduction of an anesthetic causes progression of structural changes in the gingival tissue.

Keyword

Anesthetic Delivery; Dentistry; Infiltration; Local Anesthesia; Oral Mucosa

MeSH Terms

Anesthesia, Local
Animals
Carticaine
Dentistry
Estrogens, Conjugated (USP)
Glucose
Humans
Male
Microcirculation
Mouth Mucosa
Rats
Carticaine
Estrogens, Conjugated (USP)
Glucose

Figure

• 

  Fig. 1 Periodontal tissues. Hematoxylin and eosin (H&E) staining (200 ×). (1-1) Control. Histological changes are absent, (1-2) Rapid introduction of the drug. Severe infiltration (arrow) and signs of aseptic inflammation, (1-3) Rapid introduction of the drug. Severe infiltration and signs of aseptic inflammation, microvascular spasm. The splitting of the epithelium, (1-4) Slow injection of the drug. Minimal signs of reaction from the bloodstream in the form of spasm of the capillaries (arrow) and the formation of “sludge complexes” (aggregation and agglutination of red blood cells).

• 

  Fig. 2 Fast intraligamentary introduction of the anesthetic solution. (2-1) Destruction of the dentogingival ligament (A) with moderate edema of the mucosa and submucosa (B) of the adjacent gums. (2-2) Destruction of the dentogingival ligament (B) with moderate edema of the mucosa and submucosa (A) of the adjacent gums. Hematoxylin and eosin (H&E) staining (200 ×).

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