Comparative evaluation of the effect of IANB and Ancillary Intra- ligamentary injections in pediatric patients with deep carious lesions in permanent mandibular molars
Main Article Content
Keywords
Lignocaine, Immature permanent teeth, Pulpal anesthesia and IANB
Abstract
Aim: The goal of this study was to investigate the effects of three types of preoperative pulpal anesthesia in the deeper lesion permanent mandibular teeth of pediatric patients: (1) inferior alveolar nerve block (IANB); (2) Ancillary intraligamentary injection (SII); and (3) Anaesthetic for the pulp during invasive Dental Surgery.
Materials and methods: In the beginning, IANB is utilized to numb the important permanent mandibular molars that had significant cavities. When the molar failed to respond to sensitivity tests used to gauge the effectiveness of the pretreatment pulpal anesthetic, the procedure was deemed successful. When pretreatment pulpal anesthesia failed, a SII was given and the state of the anesthesia was reviewed. There could be a total of three SIIs. When the patients' assessed Wong-Baker FACES Pain Rating Scale was no higher than four during surgery, pulpal anesthesia was determined.
Results: Patients between the ages of 10.9 sixty molars. Following IANB, 26.7 percent of preoperative pulpal anesthetic procedures were successful. SIIs were used in circumstances where the IANB had failed. Preoperative pulpal anesthesia had an 80 percent total cumulative chances of success. The success rate of Anaesthetic for the pulp during invasive Dental Surgery was 72.9 percent.
Conclusion: In immature permanent teeth with severe cavities, pulpal anesthesia by the inferior alveolar block had a low rate of success. Preoperative pulpal analgesia can be significantly improved with an additional intraligamentary injection, however 27.1 percent of patients reported discomfort throughout treatment.
References
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33. Iwanaga J, Choi PJ, Vetter M, Patel M, Kikuta S, Oskouian RJ, et al. Anatomical Study of the Lingual Nerve and Inferior Alveolar Nerve in the Pterygomandibular Space: Complications of the Inferior Alveolar Nerve Block [Internet]. Cureus. 2018. Available from: http://dx.doi.org/10.7759/cureus.3109
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2. Li Z, Yang M, Liao T, Zhou Y, Yue H, Piao Z, et al. Combined inferior alveolar nerve block anaesthesia and local infiltration anaesthesia in extraction of impacted mandibular third molars: a randomised controlled trial [Internet]. British Dental Journal. 2020. Available from: http://dx.doi.org/10.1038/s41415-020-2002-z
3. Yu J, Liu S, Zhang X. Can buccal infiltration of articaine replace traditional inferior alveolar nerve block for the treatment of mandibular molars in pediatric patients?: A systematic review and meta-analysis. Med Oral Patol Oral Cir Bucal. 2021 Nov 1;26(6):e754–61.
4. Chompu-Inwai P, Sutharaphan T, Nirunsittirat A, Chuveera P, Srisuwan T, Sastraruji T. How Effective are Inferior Alveolar Nerve Block and Supplemental Intraligamentary Injections in Pediatric Patients with Deep Carious Permanent Mandibular Molars? Pediatr Dent. 2018 Nov 15;40(7):437–42.
5. Chompu-Inwai P, Bua-On P, Nirunsittirat A, Chuveera P, Louwakul P, Sastraruji T. Pulpal anesthesia in pediatric patients following supplemental mandibular buccal infiltration in vital permanent mandibular molars with deep caries. Clin Oral Investig. 2020 Feb;24(2):945–51.
6. Garcia B. Ultrasound for intrathecal injections in pediatric patients with severe scoliosis: isolated use or common practice? [Internet]. Available from: http://dx.doi.org/10.26226/morressier.58f5b033d462b80296c9dcd9
7. Asnani KH. Essentials of Pediatric Dentistry. Jaypee Brothers,Medical Publishers Pvt. Limited; 2010. 260 p.
8. Brill W. Behavior of pediatric dental patients throughout the course of restorative dental treatment in a private pediatric dental practice [Internet]. Vol. 26, Journal of Clinical Pediatric Dentistry. 2002. p. 55–60. Available from: http://dx.doi.org/10.17796/jcpd.26.1.5657p372502l5180
9. Yamada A, Fukumoto S, Kamasaki Y, Kubota K, Fujiwara T. Magnetic attachment for denture type appliance in pediatric patients [Internet]. Vol. 14, Pediatric Dental Journal. 2004. p. 69–77. Available from: http://dx.doi.org/10.1016/s0917-2394(04)70011-7
10. Gelfand AA, Reider AC, Goadsby PJ. Outcomes of Greater Occipital Nerve Injections in Pediatric Patients With Chronic Primary Headache Disorders [Internet]. Vol. 50, Pediatric Neurology. 2014. p. 135–9. Available from: http://dx.doi.org/10.1016/j.pediatrneurol.2013.09.008
11. Priyadarshini P, Jeevanandan G, Govindaraju L, Subramanian EMG. Clinical evaluation of instrumentation time and quality of obturation using paediatric hand and rotary file systems with conventional hand K-files for pulpectomy in primary mandibular molars: a double-blinded randomized controlled trial. Eur Arch Paediatr Dent. 2020 Dec;21(6):693–701.
12. Jeevanandan G, Juliet S, Govindaraju L, Ravindran V, Subramanian E. Comparison between three rotary files on quality of obturation and instrumentation time in primary teeth − A double blinded randomized controlled trial. J Orofac Sci. 2020 Jan 1;12(1):30.
13. Divya S, Jeevanandan G, Sujatha S, Subramanian EMG, Ravindran V. Comparison of quality of obturation and post-operative pain using manual vs rotary files in primary teeth - A randomised clinical trial. Indian J Dent Res. 2019 Nov-Dec;30(6):904–8.
14. Jeevanandan G, Govindaraju L, Subramanian EMG, Priyadarshini P. Comparative Evaluation of Quality of Obturation and Its Effect on Postoperative Pain between Pediatric Hand and Rotary Files: A Double-blinded Randomized Controlled Trial. Int J Clin Pediatr Dent. 2021 Jan-Feb;14(1):88–96.
15. Preethy NA, Jeevanandan G, Mathew MG, Subramanian EM. Evaluation of Quality of Obturation Using Two Different Rotary Files and Hand Files in Primary Teeth: A Randomized Controlled Trial. Int J Clin Pediatr Dent. 2021 Jul-Aug;14(4):471–4.
16. Aishuwariya T, Ramesh S. Comparison Of Quality Of Obturation Using Radiographs-A Retrospective Study. Int J Dentistry Oral Sci. 2021;8(6):2833–8.
17. Sruthi S, Jeevanandan G, Govindaraju L, Subramanian E. Assessing quality of obturation and instrumentation time using Kedo-SG blue, Kedo-SH, and reciprocating hand K-files in primary mandibular molars: A double-blinded randomized controlled trial. Dent Res J . 2021 Sep 25;18:76.
18. Jeevanandan G, Govindaraju L. Clinical comparison of Kedo-S paediatric rotary files vs manual instrumentation for root canal preparation in primary molars: a double blinded randomised clinical trial [Internet]. Vol. 19, European Archives of Paediatric Dentistry. 2018. p. 273–8. Available from: http://dx.doi.org/10.1007/s40368-018-0356-6
19. Jeevanandan G, Thomas E. Volumetric analysis of hand, reciprocating and rotary instrumentation techniques in primary molars using spiral computed tomography: An in vitro comparative study. Eur J Dent. 2018 Jan;12(1):21–6.
20. Jayachandar D, Gurunathan D, Jeevanandan G. Prevalence of early loss of primary molars among children aged 5-10 years in Chennai: A cross-sectional study. J Indian Soc Pedod Prev Dent. 2019 Apr-Jun;37(2):115–9.
21. Wadia R. Supplemental intraligamentary injections [Internet]. Vol. 232, British Dental Journal. 2022. p. 387–387. Available from: http://dx.doi.org/10.1038/s41415-022-4101-5
22. Supplemental Information 1: Clinical dental findings of the patients [Internet]. Available from: http://dx.doi.org/10.7717/peerj.6316/supp-1
23. Cohen L, Fancher A, MacLaren J, Lim C. Correlates of Pediatric Behavior and Distress during Intramuscular Injections for Invasive Dental Procedures [Internet]. Vol. 31, Journal of Clinical Pediatric Dentistry. 2007. p. 44–7. Available from: http://dx.doi.org/10.17796/jcpd.31.1.e803gj132m7226l6
24. Augmenting inferior alveolar nerve block [Internet]. Vol. 56, Dental Abstracts. 2011. p. 75. Available from: http://dx.doi.org/10.1016/j.denabs.2010.10.020
25. McNeil DW, Kyle BN. Summary of: Highly anxious dental patients report more pain during dental injections [Internet]. Vol. 205, British Dental Journal. 2008. p. 142–3. Available from: http://dx.doi.org/10.1038/sj.bdj.2008.681
26. Avery DR, McDonald RE, Dean JA. McDonald and Avery Dentistry for the Child and Adolescent - E-Book. Elsevier Health Sciences; 2010. 720 p.
27. Rao A. Principles and Practice Of Pedodontics. JP Medical Ltd; 2012. 529 p.
28. Malamed SF. Handbook of Local Anesthesia,6e. Elsevier India; 2012. 13 p.
29. Koch G, Poulsen S, Espelid I, Haubek D. Pediatric Dentistry: A Clinical Approach. John Wiley & Sons; 2017. 408 p.
30. Baart JA, Brand HS. Local Anaesthesia in Dentistry. John Wiley & Sons; 2013. 192 p.
31. Wright GZ, Kupietzky A. Behavior Management in Dentistry for Children. John Wiley & Sons; 2014. 546 p.
32. Fortes JHP. Influence of retromolar canal on the anesthetic block of the inferior alveolar nerve: a clinical randomized study [Internet]. Available from: http://dx.doi.org/10.11606/t.58.2019.tde-30092022-125656
33. Iwanaga J, Choi PJ, Vetter M, Patel M, Kikuta S, Oskouian RJ, et al. Anatomical Study of the Lingual Nerve and Inferior Alveolar Nerve in the Pterygomandibular Space: Complications of the Inferior Alveolar Nerve Block [Internet]. Cureus. 2018. Available from: http://dx.doi.org/10.7759/cureus.3109
34. Kumita S, Ueshima H. 2 - A cadaveric study of ultrasound-guided inferior alveolar nerve block [Internet]. Available from: http://dx.doi.org/10.26226/morressier.5d1cc24957558b317a173340
35. Waldman SD. Inferior Alveolar Nerve Block [Internet]. Atlas of Interventional Pain Management. 2015. p. 75–8.e1. Available from: http://dx.doi.org/10.1016/b978-0-323-24428-2.00021-8
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May 13, 2023
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Dinesh kumar, Vignesh Ravindran, Ganesh Jeevanandan, Lavanya, & Rajasekar. (2023). Comparative evaluation of the effect of IANB and Ancillary Intra- ligamentary injections in pediatric patients with deep carious lesions in permanent mandibular molars. Journal of Population Therapeutics and Clinical Pharmacology, 30(10), 54–61. https://doi.org/10.47750/jptcp.2023.30.10.009
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