title: Anesthetic efficacy of a repeated intraosseous injection following a primary intraosseous injection.
abstract: The purpose of this prospective, randomized, single-blinded study was to determine the anesthetic efficacy of a repeated intraosseous injection given 30 minutes after a primary intraosseous injection. Using a crossover design, 55 subjects randomly received a primary X-tip intraosseous injection (Dentsply Inc, York, PA) of 1.4 mL of 2% lidocaine with epinephrine (using the Wand; Milestone Scientific, Deerfield, IL) and a repeated intraosseous or mock injection at 30 minutes in two appointments. The first molar and adjacent teeth were pulp tested every 2 minutes for a total of 120 minutes. Success was defined as obtaining two consecutive 80 readings with the electric pulp tester. Success of the initial intraosseous injection was 100% for the first molar. The repeated intraosseous injection mimicked the initial intraosseous injection in terms of pulpal anesthesia and statistically provided another 15 minutes of pulpal anesthesia. In conclusion, using the methodology presented, repeating the intraosseous injection 30 minutes after an initial intraosseous injection will provide an additional 15 minutes of pulpal anesthesia.
authors.affiliation: Private Practice, Pleasant Hill, CA, USA.
authors.forename: Joanne
authors.initials: J
authors.lastname: Jensen
authors.forename: John
authors.initials: J
authors.lastname: Nusstein
authors.forename: Melissa
authors.initials: M
authors.lastname: Drum
authors.forename: Al
authors.initials: A
authors.lastname: Reader
authors.forename: Mike
authors.initials: M
authors.lastname: Beck
mesh_terms: D000328:Adult; D000772:Anesthesia, Local / Q000295:instrumentation; D000779:Anesthetics, Local / Q000008:administration & dosage*; D001641:Bicuspid / Q000187:drug effects; D018592:Cross-Over Studies; D003782:Dental Pulp / Q000187:drug effects; D003791:Dental Pulp Test; D004837:Epinephrine / Q000008:administration & dosage; D005260:Female; D006801:Humans; D007267:Injections / Q000295:instrumentation / Q000379:methods; D008012:Lidocaine / Q000008:administration & dosage*; D008297:Male; D008963:Molar / Q000187:drug effects; D010147:Pain Measurement; D011446:Prospective Studies; D016037:Single-Blind Method; D013997:Time Factors; D014662:Vasoconstrictor Agents / Q000008:administration & dosage
chemical_list: D000779:Anesthetics, Local; D014662:Vasoconstrictor Agents; D008012:Lidocaine; D004837:Epinephrine