title: Intraosseous anaesthesia in children with 4 % articaine and epinephrine 1:400,000 using computer-assisted systems.
abstract: OBJECTIVE
  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.
authors.affiliation: 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. jean-louis.sixou@univ-rennes1.fr.
authors.forename: J-L
authors.initials: JL
authors.lastname: Sixou
authors.affiliation: 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.
authors.forename: A
authors.initials: A
authors.lastname: Marie-Cousin
mesh_terms: D000293:Adolescent; D000539:Alveolar Process; D000766:Anesthesia, Dental / Q000295:instrumentation / Q000379:methods*; D000772:Anesthesia, Local / Q000295:instrumentation / Q000379:methods; D000779:Anesthetics, Local / Q000008:administration & dosage*; D002355:Carticaine / Q000008:administration & dosage*; D002648:Child; D002675:Child, Preschool; D003785:Dental Pulp Capping / Q000379:methods; D003793:Dental Restoration, Permanent / Q000379:methods; D004837:Epinephrine / Q000008:administration & dosage*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007267:Injections / Q000295:instrumentation / Q000379:methods; D008297:Male; D009339:Needles; D011672:Pulpotomy / Q000379:methods; D012189:Retrospective Studies; D013813:Therapy, Computer-Assisted; D014081:Tooth Extraction / Q000379:methods; D014094:Tooth, Deciduous / Q000187:drug effects; D016896:Treatment Outcome; D014662:Vasoconstrictor Agents / Q000008:administration & dosage*
chemical_list: D000779:Anesthetics, Local; D014662:Vasoconstrictor Agents; D002355:Carticaine; D004837:Epinephrine
keywords: Children; Computer-assisted dental anaesthesia; Epinephrine; Intraosseous anaesthesia