Abstract
Objective: To analyze the side effects and complications following intraosseous anesthesia (IA), comparing them with those of the conventional oral anesthesia techniques. Material and method: A simple-blind, prospective clinical study was carried out. Each patient underwent two anesthetic techniques: conventional (local infiltration and locoregional anesthetic block) and intraosseous, for respective dental operations. In order to allow comparison of IA versus conventional anesthesia, the two operations were similar and affected the same two teeth in opposite quadrants. Heart rate was recorded in all cases before injection of the anesthetic solution and again 30 seconds after injection. The complications observed after anesthetic administration were recorded. Results: A total of 200 oral anesthetic procedures were carried out in 100 patients. Both IA and conventional anesthesia resulted in a significant increase in heart rate, though the increase was greater with the latter technique. Incidents were infrequent with either anesthetic technique, with no significant differences between them. Regarding the complications, there were significant differences in pain at the injection site, with more intense pain in the case of IA (x2=3.532, p=0.030, Φ2=0.02), while the limitation of oral aperture was more pronounced with conventional anesthesia (x2=5.128, p<0.05, Φ2=0.014). Post-anesthetic biting showed no significant differences (x2=4.082, p=0.121, Φ2=0.009). Conclusions: Both anesthetic techniques significantly increased heart rate, and IA caused comparatively more pain at the injection site, while limited oral aperture was more frequent with conventional anesthesia. Post-anesthetic biting showed no significant differences between the two techniques. Key words:Intraosseous anesthesia, oral anesthesia, mandibular block, heart rate, adrenalin, complications.
Highlights
Intraosseous anesthesia (IA) allows direct placement of the anesthetic solution in the cancellous bone adjacent to the tooth programmed for anesthesia
Both anesthetic techniques significantly increased heart rate, and intraosseous anesthesia (IA) caused comparatively more pain at the injection site, while limited oral aperture was more frequent with conventional anesthesia
Post-anesthetic biting showed no significant differences between the two techniques
Summary
Intraosseous anesthesia (IA) allows direct placement of the anesthetic solution in the cancellous bone adjacent to the tooth programmed for anesthesia. In the year 2002 the American Dental Association (ADA) accepted the Stabident® system as an effective and safe technique for intraosseous pulp anesthesia, either as a primary procedure or as a complement to other anesthetic maneuvers. A number of authors have found IA to be associated with an increase in patient heart rate when the anesthetic solution contains adrenalin or levonordefrin. The administration of local anesthetics associated to adrenalin can have serious repercussions, in patients who are using tricyclic antidepressants and nonselective beta-blockers. Their use in patients with cardiovascular diseases is subject to controversy [19,20]. The present study analyzes the side effects and complications of intraosseous anesthesia, and compares them with those of conventional oral anesthesia
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