Essam Ahmed Al-Moraissi1, Abeer Mohammed Al-Selwi2, Elham Aziz Al-Zendani2. 1. Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Thamar University, Thamar, Yemen. dressamalmoraissi@gmail.com. 2. Department of Oral Surgery and Dental Implantology, College of Dentistry, University of Science and Technology, Sanaa, Yemen.
Abstract
OBJECTIVE: Association between length and gauge of dental needle and success rate and pain perception during an inferior alveolar nerve block (IANB) has not been investigated using a randomized clinical trial (RCT). This RCT aimed to compare the success rate of IANB and perceived pain using 27- or 30-gauge needles for the extraction of adult mandibular molars. MATERIAL AND METHOD: A prospective RCT was conducted on two hundred and twelve adult patients requiring extraction of mandibular molars using standard methods as described by Malamed with 1.8 ml of 2% lidocaine with 1:80,000 adrenaline. One hundred six patients received IANB using 27-gauge needles (32 mm × 0.2 mm) and one hundred six patients received IANB using 30-gauge needles (25 mm × 0.15 mm). Predictor variables were 27-gauge and short and 30-gauge. Outcome variables were the success rate of IANB and pain perception during injection using a visual analogue scale. RESULTS: There was a highly significantly increase in the success of IANB using 27-gauge needle (95.28%) versus 30-gauge needle (41.51%) (P = 0.001). There was a significant increase in pain perception for patients who received IANB by shorter and thinner needle (30-gauge) when compared to the long and thicker needle (27-gauge). CONCLUSION: This RCT demonstrated that 27-gauge needle seems to be associated with a higher success rate of IANB and lower pain perception during injection when compared to 30-gauge needle in the extraction of adult mandibular molars when compared to 30-gauge needles. CLINICAL RELEVANCE: For adult patients, when thickness of soft tissue to be penetrated is essential to achieve bony contact, long or large gauge dental needle is preferred to get a higher success rate of IANB with less pain perception during injection.
OBJECTIVE: Association between length and gauge of dental needle and success rate and pain perception during an inferior alveolar nerve block (IANB) has not been investigated using a randomized clinical trial (RCT). This RCT aimed to compare the success rate of IANB and perceived pain using 27- or 30-gauge needles for the extraction of adult mandibular molars. MATERIAL AND METHOD: A prospective RCT was conducted on two hundred and twelve adult patients requiring extraction of mandibular molars using standard methods as described by Malamed with 1.8 ml of 2% lidocaine with 1:80,000 adrenaline. One hundred six patients received IANB using 27-gauge needles (32 mm × 0.2 mm) and one hundred six patients received IANB using 30-gauge needles (25 mm × 0.15 mm). Predictor variables were 27-gauge and short and 30-gauge. Outcome variables were the success rate of IANB and pain perception during injection using a visual analogue scale. RESULTS: There was a highly significantly increase in the success of IANB using 27-gauge needle (95.28%) versus 30-gauge needle (41.51%) (P = 0.001). There was a significant increase in pain perception for patients who received IANB by shorter and thinner needle (30-gauge) when compared to the long and thicker needle (27-gauge). CONCLUSION: This RCT demonstrated that 27-gauge needle seems to be associated with a higher success rate of IANB and lower pain perception during injection when compared to 30-gauge needle in the extraction of adult mandibular molars when compared to 30-gauge needles. CLINICAL RELEVANCE: For adult patients, when thickness of soft tissue to be penetrated is essential to achieve bony contact, long or large gauge dental needle is preferred to get a higher success rate of IANB with less pain perception during injection.
Authors: Arjen van Wijk; Jerome A Lindeboom; Ad de Jongh; Jacco G Tuk; Johan Hoogstraten Journal: Oral Surg Oral Med Oral Pathol Oral Radiol Date: 2012-01-23
Authors: S Samieirad; A Sharifian-Attar; M Eshghpour; V Mianbandi; E Shadkam; M Hosseini-Abrishami; M-S Hashemipour Journal: Med Oral Patol Oral Cir Bucal Date: 2018-11-01
Authors: Lorena Batista Sandre; Elvidio de Paula E Silva; Antonio Eduardo Ribeiro Izidro; Waltencyr Mendes Pereira Neto; Cícero André da Costa Moraes; Everton Luis Santos da Rosa Journal: Oral Maxillofac Surg Date: 2022-06-06