The effectiveness of intraosseous injection for supplemental anesthesia in impacted lower third molar surgery
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Abstract
The objective of the study was to determine anesthetic success of intraosseous injection for supplemental anesthesia in impacted lower third molar surgery by using 4% articaine with epinephrine 1 : 200,000. The heart rate effect and pain during injection were also evaluated. The clinical-based, quasi-experimental study was conducted in 36 patients who experienced discomfort or pain during the process of bone removal and/or tooth sectioning in lower third molar surgery received intraosseous injection using 4% articaine with 1 : 200,000 epinephrine, 0.6-0.9 ml in 30 seconds. The anesthetic success was evaluated by absence of pain during bone removal and tooth sectioning until complete tooth removal. The heart rate effect was measured by pulse oximeter before injection and in 1-minute intervals for 5 minutes. The pain during injection was recorded using verbal numerical rating scale. For the results, the anesthetic success of intra-osseous injection for supplemental anesthesia was over 90% (binomial test; p = 0.289). The heart rate was maximally increased in the first minute (mean = 4.24 ± 9.30%) after injection. The median and interquartile range of verbal numerical rating scale of pain during injection were 2 and 3.5, respectively. For conclusion, the intraosseous injection is an advantageous anesthetic technique. It can be used as a supplemental injection to conventional inferior alveolar nerve block for impacted mandibular third molar surgery.
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