INTRODUCTION: To evaluate the impact of experience whilst using different devices for intraligamentary anaesthesia, dental students tested clinical anaesthetic efficacy of a mechanical (PDL-S) and a computer-controlled (CCLAD) application system in restorative patients. MATERIAL AND METHODS: In a prospective study, 41 Patients in need of restorative treatment in lower posterior mandible were randomised into three groups (PDL-S: teeth n = 22; CCLAD: teeth n = 20; inferior alveolar nerve block (IANB): teeth n = 20). Dental last year students conducted anaesthesia and dental treatment. Primary objectives were differences in pain during treatment [numeric rating scale (NRS)] as well as in anaesthetic efficacy (complete/sufficient vs. insufficient/no effect) between PDL-S and CCLAD. Pain of injection, need for second injections, amount of anaesthetic solution and duration of local numbness were assessed. IANB as gold standard was compared to each system descriptively. RESULTS: PDL-S had a significant lower pain during treatment (P = 0.017) but a similar anaesthetic efficacy (P = 0.175) compared to the CCLAD system. Concerning pain of injection (P = 0.42), quantity of second injections (P = 0.232), amount of used solution (P = 0.073) as well as duration of local numbness (P = 0.253), no differences were seen. When comparing both periodontal ligament injection (PDL)-systems with IANB, pain rating was higher when using CCLAD. Injection pain, amount of used solution as well as soft tissue anaesthesia was less for PDL-S and CCLAD. DISCUSSION: Both PDL techniques showed a good success for dental routine treatments. Although, compared to the mechanic device, the CCLAD system might need more clinical daily experience. CONCLUSION: We recommend including specific trainings in intraligamentary anaesthesia in the dental curriculum.
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INTRODUCTION: To evaluate the impact of experience whilst using different devices for intraligamentary anaesthesia, dental students tested clinical anaesthetic efficacy of a mechanical (PDL-S) and a computer-controlled (CCLAD) application system in restorative patients. MATERIAL AND METHODS: In a prospective study, 41 Patients in need of restorative treatment in lower posterior mandible were randomised into three groups (PDL-S: teeth n = 22; CCLAD: teeth n = 20; inferior alveolar nerve block (IANB): teeth n = 20). Dental last year students conducted anaesthesia and dental treatment. Primary objectives were differences in pain during treatment [numeric rating scale (NRS)] as well as in anaesthetic efficacy (complete/sufficient vs. insufficient/no effect) between PDL-S and CCLAD. Pain of injection, need for second injections, amount of anaesthetic solution and duration of local numbness were assessed. IANB as gold standard was compared to each system descriptively. RESULTS: PDL-S had a significant lower pain during treatment (P = 0.017) but a similar anaesthetic efficacy (P = 0.175) compared to the CCLAD system. Concerning pain of injection (P = 0.42), quantity of second injections (P = 0.232), amount of used solution (P = 0.073) as well as duration of local numbness (P = 0.253), no differences were seen. When comparing both periodontal ligament injection (PDL)-systems with IANB, pain rating was higher when using CCLAD. Injection pain, amount of used solution as well as soft tissue anaesthesia was less for PDL-S and CCLAD. DISCUSSION: Both PDL techniques showed a good success for dental routine treatments. Although, compared to the mechanic device, the CCLAD system might need more clinical daily experience. CONCLUSION: We recommend including specific trainings in intraligamentary anaesthesia in the dental curriculum.
Authors: Daniel G E Thiem; Florian Schnaith; Caroline M E Van Aken; Anne Köntges; Vinay V Kumar; Bilal Al-Nawas; Peer W Kämmerer Journal: Clin Oral Investig Date: 2017-10-17 Impact factor: 3.573