J Dent Anesth Pain Med.  2020 Feb;20(1):9-17. 10.17245/jdapm.2020.20.1.9.

Clinical evaluation of efficacy of transcortical anesthesia for the extraction of impacted mandibular third molars: a randomized controlled trial

• Demir E
• Ataoglu H

• KMID: 2471169
• DOI: http://doi.org/10.17245/jdapm.2020.20.1.9

Abstract

BACKGROUND
This study aimed to compare the pain levels during anesthesia and the efficacy of the QuickSleeper intraosseous (IO) injection system and conventional inferior alveolar nerve block (IANB) in impacted mandibular third molar surgery.
METHODS
This prospective randomized clinical trial included 30 patients (16 women, 14 men) with bilateral symmetrical impacted mandibular third molars. Thirty subjects randomly received either the IO injection or conventional IANB at two successive appointments. A split-mouth design was used in which each patient underwent treatment of a tooth with one of the techniques and treatment of the homologous contralateral tooth with the other technique. The subjects received 1.8 mL of 2% articaine. Subjects' demographic data, pain levels during anesthesia induction, tooth extractions, and mouth opening on postoperative first, third, and seventh days were recorded. Pain assessment ratings were recorded using the 100-mm visual analog scale. The latency and duration of the anesthetic effect, complications, and operation duration were also analyzed in this study. The duration of anesthetic effect was considered using an electric pulp test and by probing the soft tissue with an explorer.
RESULTS
Thirty patients aged between 18 and 47 years (mean age, 25 years) were included in this study. The IO injection was significantly less painful with lesser soft tissue numbness and quicker onset of anesthesia and lingual mucosa anesthesia with single needle penetration than conventional IANB. Moreover, 19 out of 30 patients (63%) preferred transcortical anesthesia. Mouth opening on postoperative first day was significantly better with intraosseous injection than with conventional IANB (P = 0.013).
CONCLUSION
The IO anesthetic system is a good alternative to IANB for extraction of the third molar with less pain during anesthesia induction and sufficient depth of anesthesia for the surgical procedure.

Keyword

Impacted Tooth; Intraosseous; QuickSleeper; Transcortical Anesthesia

MeSH Terms

Anesthesia*
Anesthetics
Appointments and Schedules
Carticaine
Female
Humans
Hypesthesia
Jupiter
Mandibular Nerve
Molar, Third*
Mouth
Mucous Membrane
Needles
Pain Measurement
Prospective Studies
Tooth
Tooth Extraction
Tooth, Impacted
Visual Analog Scale
Anesthetics
Carticaine

Figure

• 

  Fig. 1 QuickSleeper device has been set up (a) Anesthetic solution is deposited in the distal cancellous bone adjacent to the mandibular third molar tooth to be anesthetized (b)

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