Clinical Oral Investigations

, Volume 22, Issue 3, pp 1523–1530 | Cite as

Extraction of mandibular premolars and molars: comparison between local infiltration via pressure syringe and inferior alveolar nerve block anesthesia

  • Daniel G. E. Thiem
  • Florian Schnaith
  • Caroline M. E. Van Aken
  • Anne Köntges
  • Vinay V. Kumar
  • Bilal Al-Nawas
  • Peer W. Kämmerer
Original Article
  • 143 Downloads

Abstract

Objectives

The purpose of this study was to evaluate the anesthetic efficiency of local infiltration anesthesia administered with a pressure syringe (P-INF) via a special technique versus direct block anesthesia of the inferior alveolar nerve (IANB) for tooth extraction in the posterior mandible.

Materials and methods

In a prospective randomized study, 101 teeth in 101 patients were extracted in the posterior mandible under local anesthesia whereby two different administration techniques were used (P-INF n = 48; IANB n = 53). Primary objectives were comparisons of anesthetic success rate (yes/no) and efficacy (full/sufficient vs. insufficient). Secondary objectives were patients’ pain perception during treatment, pain of injection (numerical rating scale), need for second injections (always IANB), time until onset of anesthetic action (min), and duration of local numbness (min).

Results

IANB was successful in all cases, whereas initial P-INF achieved 35% of success only. Furthermore, IANB reached significant higher values of anesthetic efficacy compared to P-INF (P < 0.001). Concerning pain of injection, patients rated IANB to be more painful (P = 0.039). Second injections were significantly more often necessary for P-INF (P = 0.006) whereas duration until onset of action as well as the duration of local numbness were found to be equal.

Conclusions

For anesthetic efficacy as well as anesthetic success, block anesthesia of the inferior alveolar nerve (IANB) turned out to be more proficient to local infiltration via special delivering system with a special technique.

Clinical relevance

Infiltration, even when performed with 4% articaine and a pressure syringe system, is not a suitable method of anesthesia in the posterior mandible.

Keywords

Anesthetic success IANB Mandibular molar tooth extraction Molar region of the mandible Local anesthesia Pressure syringe system 

Notes

Author Contributions

All the authors of this manuscript had substantial contribution to the conception and design or acquisition, analysis, and interpretation of data; all revised it critically for important intellectual content and did the final approval of the version to be published. All authors read and approved the final manuscript. D.G.E. Thiem (daniel.thiem@med.uni-rostock.de) takes responsibility for the integrity of the work as a whole, from inception to finished article.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.

Supplementary material

784_2017_2251_MOESM1_ESM.docx (28 kb)
ESM 1 (DOCX 27 kb)

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Copyright information

© Springer-Verlag GmbH Germany 2017

Authors and Affiliations

  • Daniel G. E. Thiem
    • 1
  • Florian Schnaith
    • 2
  • Caroline M. E. Van Aken
    • 3
  • Anne Köntges
    • 1
    • 4
  • Vinay V. Kumar
    • 5
  • Bilal Al-Nawas
    • 2
  • Peer W. Kämmerer
    • 1
  1. 1.Department of Oral and Maxillofacial Surgery, Facial Plastic SurgeryUniversity Medical Centre RostockRostockGermany
  2. 2.Department of Oral and Maxillofacial Surgery, Facial Plastic SurgeryUniversity Medical Centre MainzMainzGermany
  3. 3.Department of GynecologyUniversity Medical Centre Hamburg-EppendorfHamburgGermany
  4. 4.Department of Operative Dentistry and PeriodontologyUniversity Medical Centre RostockRostockGermany
  5. 5.Head and Neck Institute, Mazumdar Shaw Cancer CenterNarayana HealthBangaloreIndia

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