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Intraosseous anaesthesia in children with 4 % articaine and epinephrine 1:400,000 using computer-assisted systems

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European Archives of Paediatric Dentistry Aims and scope Submit manuscript

Abstract

Aim

To assess retrospectively the efficacy of computer-assisted intraosseous anaesthesia (CAIO) in children using an anaesthetic solution with a lower concentration of epinephrine (1:400,000).

Methods

In a retrospective study, CAIO was evaluated in healthy children and adolescents for restorative and endodontic treatments, uncomplicated tooth extractions or scalings using articaine 4 % plus epinephrine 1:400,000. Anaesthesia was performed in children who showed enough compliance (score of 0–3 according to modified behaviour Venham scale). Efficacy, amount of anaesthetic solution as well as need of a complementary injection was assessed.

Results

A total of 421 consecutive sessions were performed on 278 patients aged 7.1 ± 2.9 years with 518 teeth involved in the anaesthetic process and analysed process. When teeth to be anaesthetised were considered, the overall success rate was 97.2 %. In most of the cases, only 0.9 mL was needed to achieve anaesthesia. Permanent teeth needed significantly more anaesthetics than primary teeth. Sensitivity of the teeth anaesthetized reappeared in 5.7 % of cases after 30–60 min of treatment.

Conclusions

These results suggest that CAIO with 4 % articaine and epinephrine diluted 1:400,000 can be an alternative to usual infiltration techniques or IO with epinephrine at a higher concentration for most of treatments in primary and permanent teeth. Further studies are needed to evaluate its efficacy in permanent teeth in case of endodontic treatment or extraction.

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References

  • Beneito-Brotons R, Peñarrocha-Oltra D, Ata-Ali J, Peñarrocha M. Intraosseous anesthesia with solution injection controlled by a computerized system versus conventional oral anesthesia: a preliminary study. Med Oral Patol Oral Cir Bucal. 2012;17:e426–9.

    Article  PubMed Central  PubMed  Google Scholar 

  • Bigby J, Reader A, Nusstein J, Beck M, Weaver J. Articaine for supplemental intraosseous anesthesia in patients with irreversible pulpitis. J Endod. 2006;32:1044–7.

    Article  PubMed  Google Scholar 

  • Chamberlain TM, Davis RD, Murchison DF, Hansen SR, Richardson BW. Systemic effects of an intraosseous injection of 2 % lidocaine with 1:100,000 epinephrine. Gen Dent. 2000;48:299–302.

    PubMed  Google Scholar 

  • Coggins R, Reader A, Nist R, Beck M, Meyers WJ. Anesthetic efficacy of the intraosseous injection in maxillary and mandibular teeth. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 1996;81:634–41.

    Article  PubMed  Google Scholar 

  • Collado V, Hennequin M, Faulks D, et al. Modification of behavior with 50 % nitrous oxide/oxygen conscious sedation over repeated visits for dental treatment a 3-year prospective study. J Clin Psychopharmacol. 2006;26:474–81.

    Article  PubMed  Google Scholar 

  • Daubländer M, Kämmerer PW, Willershausen B, et al. Clinical use of an epinephrine-reduced (1/400,000) articaine solution in short time dental routine treatments—a multicenter study. Clin Oral Investig. 2012;16:1289–95.

    Article  PubMed  Google Scholar 

  • Dunbar D, Reader A, Nist R, Beck M, Meyers WJ. Anesthetic efficacy of the intraosseous injection after an inferior alveolar nerve block. J Endod. 1996;22:481–6.

    Article  PubMed  Google Scholar 

  • Gallatin J, Reader A, Nusstein J, Beck M, Weaver J. A comparison of two intraosseous anesthetic techniques in mandibular posterior teeth. J Am Dent Assoc. 2003;134:1476–84.

    Article  PubMed  Google Scholar 

  • Guglielmo A, Reader A, Nist R, Beck M, Weaver J. Anesthetic efficacy and heart rate effects of the supplemental intraosseous injection of 2 % mepivacaine with 1:20,000 levonordefrin. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 1999;87:284–93.

    Article  PubMed  Google Scholar 

  • Jensen J, Nusstein J, Drum M, Reader A, Beck M. Anesthetic efficacy of a repeated intraosseous injection following a primary intraosseous injection. J Endod. 2008;34:126–30.

    Article  PubMed  Google Scholar 

  • Kämmerer PW, Krämer N, Esch J, et al. Epinephrine-reduced articaine solution (1:400,000) in paediatric dentistry: a multicentre non-interventional clinical trial. Eur Arch Paediatr Dent. 2013;14:89–95.

    Article  PubMed Central  PubMed  Google Scholar 

  • Lilienthal B, Reynolds AK. Cardiovascular responses to intraosseous injections containing catecholamines. Oral Surg Oral Med Oral Pathol. 1975;40:574–83.

    Article  PubMed  Google Scholar 

  • Nusstein J, Reader A, Nist R, Beck M, Meyers WJ. Anesthetic efficacy of the supplemental intraosseous injection of 2 % lidocaine with 1:100,000 epinephrine in irreversible pulpitis. J Endod. 1998;24:487–91.

    Article  PubMed  Google Scholar 

  • Özer S, Yaltirik M, Kirli I, Yargic I. A comparative evaluation of pain and anxiety levels in 2 different anesthesia techniques: locoregional anesthesia using conventional syringe versus intraosseous anesthesia using a computer-controlled system (Quicksleeper). Oral Surg Oral Med Oral Pathol Oral Radiol. 2012;114(suppl 5):S132–9.

    Article  PubMed  Google Scholar 

  • Peñarrocha-Oltra D, Ata-Ali J, Oltra-Moscardo MJ, Peñarrocha-Diago M, Peñarrocha M. Side effects and complications of intraosseous anesthesia and conventional oral anesthesia. Med Oral Patol Oral Cir Bucal. 2012;17:e430–4.

    Article  PubMed Central  PubMed  Google Scholar 

  • Pinto Pereira LA, de Cássia Bergamaschi C, Cama Ramacciato J, Ranamli J. Articaine (4 %) with epinephrine (1:100,000 or 1:200,000) in intraosseous injections in symptomatic irreversible pulpitis of mandibular molars: anesthetic efficacy and cardiovascular effects. Oral Surg Oral Med Oral Pathol Oral Radiol. 2013;116:e85–91.

    Article  Google Scholar 

  • Remmers T, Glickman G, Spears R, He J. The efficacy of intraflow intraosseous injection as a primary anesthesia technique. J Endod. 2008;34:280–3.

    Article  PubMed  Google Scholar 

  • Replogle K, Reader A, Nist R, et al. Anesthetic efficacy of the intraosseous injection of 2 % lidocaine (1:100,000 epinephrine) and 3 % mepivacaine in mandibular first molars. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 1997;83:30–7.

    Article  PubMed  Google Scholar 

  • Replogle K, Reader A, Nist R, et al. Cardiovascular effects of intraosseous injections of 2 percent lidocaine with 1:100,000 epinephrine and 3 percent mepivacaine. J Am Dent Assoc. 1999;130:649–57.

    Article  PubMed  Google Scholar 

  • Sixou JL, Barbosa-Rogier ME. Efficacy of intraosseous injections of anesthetic in children and adolescents. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2008;106:173–8.

    Article  PubMed  Google Scholar 

  • Sixou JL, Marie-Cousin A, Huet A, Hingant B, Robert JC. Pain assessment by children ans adolescents during intraosseous anaesthesia using a computerized system (Quick Sleeper). Int J Paediatr Dent. 2009;19:360–6.

    Article  PubMed  Google Scholar 

  • Stabile P, Reader A, Gallatin E, Beck M, Weaver J. Anesthetic efficacy and heart rate effects of the intraosseous injection of 1.5 % etidocaine (1:200,000 epinephrine) after an inferior alveolar nerve block. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2000;89:407–11.

    Article  PubMed  Google Scholar 

  • Susi L, Reader A, Nusstein J, et al. Heart rate effects of intraosseous injections using slow and fast rates of anesthetic solution deposition. Anesth Prog. 2008;55:9–15.

    Article  PubMed Central  PubMed  Google Scholar 

  • Wood M, Reader A, Nusstein J, et al. Comparison of intraosseous and infiltration injections for venous lidocaine blood concentrations and heart rate changes after injection of 2 % lidocaine with 1:100,000 epinephrine. J Endod. 2005;31:435–8.

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Paediatric Dentistry, UFR d’Odontologie, University of Rennes 1 and CHU de Rennes, 2, avenue du Pr Léon Bernard, 35043, Rennes Cedex, France

    J.-L. Sixou & A. Marie-Cousin

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  1. J.-L. Sixou
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  2. A. Marie-Cousin
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Correspondence to J.-L. Sixou.

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Sixou, JL., Marie-Cousin, A. Intraosseous anaesthesia in children with 4 % articaine and epinephrine 1:400,000 using computer-assisted systems. Eur Arch Paediatr Dent 16, 477–481 (2015). https://doi.org/10.1007/s40368-015-0197-5

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  • DOI: https://doi.org/10.1007/s40368-015-0197-5

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