title: Anesthetic efficacy of a repeated intraosseous injection given 30 min following an inferior alveolar nerve block/intraosseous injection.
abstract: To determine whether a repeated intraosseous (IO) injection would increase or prolong pulpal anesthesia, we measured the degree of anesthesia obtained by a repeated IO injection given 30 min following a combination inferior alveolar nerve block/intraosseous injection (IAN/IO) in mandibular second premolars and in first and second molars. Using a repeated-measures design, we randomly assigned 38 subjects to receive two combinations of injections at two separate appointments. The combinations were an IAN/IO injection followed approximately 30 min later by another IO injection of 0.9 ml of 2% lidocaine with 1:100,000 epinephrine and a combination IAN/IO injection followed approximately 30 min later by a mock IO injection. The second premolar, first molar, and second molar were blindly tested with an Analytic Technology pulp tester at 2-min cycles for 120 min postinjection. Anesthesia was considered successful when two consecutive readings of 80 were obtained. One hundred percent of the subjects had lip numbness with IAN/IO and with IAN/IO plus repeated IO techniques. Rates of anesthetic success for the IAN/IO and for the IAN/IO plus repeated IO injection, respectively, were 100% and 97% for the second premolar, 95% and 95% for the first molar, and 87% and 87% for the second molar. The repeated IO injection increased pulpal anesthesia for approximately 14 min in the second premolar and for 6 min in the first molar, but no statistically significant differences (P > 0.05) were shown. In conclusion, the repeated IO injection of 0.9 ml of 2% lidocaine with 1:100,000 epinephrine given 30 min following a combination IAN/IO injection did not significantly increase pulpal anesthesia in mandibular second premolars or in first and second molars.
authors.affiliation: Section of Graduate Endodontics, College of Dentistry, Ohio State University, Columbus 43210, USA.
authors.forename: J
authors.initials: J
authors.lastname: Reitz
authors.forename: A
authors.initials: A
authors.lastname: Reader
authors.forename: R
authors.initials: R
authors.lastname: Nist
authors.forename: M
authors.initials: M
authors.lastname: Beck
authors.forename: W J
authors.initials: WJ
authors.lastname: Meyers
mesh_terms: D000293:Adolescent; D000328:Adult; D000766:Anesthesia, Dental / Q000379:methods*; D000779:Anesthetics, Local / Q000008:administration & dosage*; D001842:Bone and Bones; D003791:Dental Pulp Test; D006801:Humans; D007267:Injections / Q000379:methods; D008012:Lidocaine / Q000008:administration & dosage*; D008340:Mandibular Nerve; D009407:Nerve Block / Q000379:methods*; D017063:Outcome Assessment, Health Care; D018709:Statistics, Nonparametric; D011795:Surveys and Questionnaires
chemical_list: D000779:Anesthetics, Local; D008012:Lidocaine