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RS 48 Anesthetic efficacy of intraosseous injection in maxillary and mandibular teeth
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Anesthetic Efficacy and Cardiovascular Effects of the Intraosseous Injection. K. REPLOGLE*, A. READER, R. NIST, M. BECK, W. MEYERS, J. WEAVER. The Ohio State University, Col., OH The purpose of this study was to determine the anesthetic efficacy and cardiovascular effects,of the primary intraosseous injection (IO), using the Stabident ~ system, of 2% lidocaine (100,000 epi) and 3% mepivacaine in human mandibular 1st molars. Using a repeated-measures design, 42 subjects randomly received IO injections (on the distal of the 1st molar) of either 1.8 ml of 2% lidocaine (100,000 epi) or 1.8 ml of 3% mepivacaine, in a double-blind manner, at two successive appointments. The 1st molar and contralateral canine (+ & controls) were blindly tested with an Analytic Technology pulp tester at 2 rain cycles for 60 rain. Cardiovascular parameters [heart rate (HR) and blood pressure (BP)] were recorded, using EKG and Dinemap~monitors, at baseline and during and after anesthetic administration. Anesthetic success was defined as no subject response to the maximum output of the pulp tester (80 reading). Anesthetic success was statistically significant (p<0.05), as analyzed by McNemar tests, between the 2% lidocaine with 1:100,000 epi (74% success) and 3% mepivacaine (45% suqcess). ANOVA analysis showed there were no differences between the solutions regarding systolic or diastolic BP.; HR was significantly increased, during and 2 min after deposition, with 2% lidocalne (1:100,000 epi). We concluded that the IO injection of 2 % lidocaine (1:100.000). as a primary technique in mandibular 1st molars, was more effective than 3 % mepivacaine and caused an increase in heart rate. Supported by the Graduate Students Research Fund.
The Combination IAN/IO for Mandibular First Molar Anesthesia. D. DUNBAR*, A. READER, R. NIST, M. BECK, W. MEYERS. The Ohio State University, Columbus, OH The purpose of this study was to determine the contribution of the intraosseous injection (IO), using the Stabiden~ system, to the inferior alveolar nerve block (IAN) in human first molars. Using a repeated-measures design, 40 subjects randomly received either a combination IAN block (2% lidocaine [100,000 epi]) + IO injection (on the distal of the first molar) using 1.8 ml of 2% lidocalne (1:100,000 epi) or an IAN block (2 % lidocaine [1:100,000 epi]) + mock IO injection (gingival penetration only) at two successive appointments. The first molar and contralateral canine (+ & - controls) were blindly tested with an Analytic Technology pulp tester at 2 min cycles for 60 min. Anesthetic success was defined as no subject response to the maximum output of the pulp tester (80 reading) within 15 rains and maintenance of this reading for 60 mins. One hundred percent of all subjects had lip numbness. Anesthetic success and failure were statistically significant (p<0.05), as analyzed by McNemar tests, between the IAN (42% S, 32% F) and IAN + IO (90% S, 0% F). For the IAN + IO injection, onset was immediate and 80% of subjects sampled felt an increase in heart rate. We concluded that adding the IO injection to an IAN block significantly increased anesthetic success in the first molar. This study was supported by the Graduate Students Research Fund, Dept. of Endodontics.
Anesthetic Efficacy of Intraosseous Injection In Maxillary and Mandibular Teeth. R. COGGINS*, A. READER, R. NIST, M. BECK, W. MEYERS. The Ohio State University, Columbus, OH The purpose of this study was to determine the anestheti,,~ efficacy of the intraosseous injection (IO), using the Stabident ~ system, as a primary technique in human 1st molars and lateral incisors. Forty subjects received two sets of IO injections (on the distal of each experimental tooth), using 1.8 ml of 2% lidocaine (1:100,000 epi.), at two successive appointments. The experimental teeth consisted of 40 maxillary and mandibular 1st molars and lateral incisors. Each experimental tooth and contralateral canine (+ & - controls) were blindly tested with an Analytic Technology pulp tester at 4 rain cycles for 60 min. Anesthetic success was defined as no subject response to the maximum output of the pulp tester (80 reading). Anesthetic success occurred in: 75% of mandibular 1st molars; in 93% of maxillary 1st molars; in 90% of maxillary lateral incisors; in 78% of mandibular lateral incisors. For the IO injection: onset was immediate; the duration steadily decreased over the 60 min; there was a 78 % incidence of subjective increase in heart rate; there was a low incidence (< 15%) of moderate pain with perforation and solution deposition; and 3% of subjects had slow healing perforation sites. We concluded that the IO injection as a primary technique offers few advantages to a ~tandard infiltration and/or nerve block. This study was supported by the Graduate Students Research Fund, Dept. of Endodontics.
Residual Endotoxin on Endodontic Files After Routine Infection Control Procedures. K.W. Tittle*, J.D. Kettering, M.TorabineJad. Loma Linda University, Loma Linda, California. Endotoxin present in the infected canals of teeth is relatively heat stable and unaffected by conventional autoclaving. This study examined the efficacy of current sterilization techniques on endotoxin contaminated endodontic files. Sixty-four files were divided into eight groups of eight each. Files in group I were not contaminated and received no treatment (- controls). Groups II through IV were contaminated with E. coil endotoxin (5pg/ml) and were treated as follows: Group II (+ control) received no treatment. Files in group III were autoclaved. Files in group IV were cleaned in an ultrasonic bath (10 min) then autoclaved. Files in groups V and VI were not contaminated and were treated as groups Ill and IV. Files in group VII and VIII were contaminated with a culture of E. coil and autoclaved. Files in group VIII were then immersed in 5.25% NaOCI for ten seconds. Presence of endotoxin was measured with the Limulus Amebocyte Lysate Chromogenic test. Data was analyzed by individual t-tests. Cleaning files in an ultrasonic bath plus autoclaving completely eliminated measurable endotoxin. The average amount of endotoxin present on each file after culture contamination and autoclaving was 922 Eu. The results show that autoclaving and immersion in NaOCI siqnificantl¥ reduce (p<.001), but do not eliminate endotoxin from contaminated endodontic files.
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RSl 481
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Anesthetic Efficacy and Cardiovascular Effects of the Intraosseous Injection. K. REPLOGLE*, A. READER, R. NIST, M. BECK, W. MEYERS, J. WEAVER. The Ohio State University, Col., OH The purpose of this study was to determine the anesthetic efficacy and cardiovascular effects,of the primary intraosseous injection (IO), using the Stabident ~ system, of 2% lidocaine (100,000 epi) and 3% mepivacaine in human mandibular 1st molars. Using a repeated-measures design, 42 subjects randomly received IO injections (on the distal of the 1st molar) of either 1.8 ml of 2% lidocaine (100,000 epi) or 1.8 ml of 3% mepivacaine, in a double-blind manner, at two successive appointments. The 1st molar and contralateral canine (+ & controls) were blindly tested with an Analytic Technology pulp tester at 2 rain cycles for 60 rain. Cardiovascular parameters [heart rate (HR) and blood pressure (BP)] were recorded, using EKG and Dinemap~monitors, at baseline and during and after anesthetic administration. Anesthetic success was defined as no subject response to the maximum output of the pulp tester (80 reading). Anesthetic success was statistically significant (p<0.05), as analyzed by McNemar tests, between the 2% lidocaine with 1:100,000 epi (74% success) and 3% mepivacaine (45% suqcess). ANOVA analysis showed there were no differences between the solutions regarding systolic or diastolic BP.; HR was significantly increased, during and 2 min after deposition, with 2% lidocalne (1:100,000 epi). We concluded that the IO injection of 2 % lidocaine (1:100.000). as a primary technique in mandibular 1st molars, was more effective than 3 % mepivacaine and caused an increase in heart rate. Supported by the Graduate Students Research Fund.
The Combination IAN/IO for Mandibular First Molar Anesthesia. D. DUNBAR*, A. READER, R. NIST, M. BECK, W. MEYERS. The Ohio State University, Columbus, OH The purpose of this study was to determine the contribution of the intraosseous injection (IO), using the Stabiden~ system, to the inferior alveolar nerve block (IAN) in human first molars. Using a repeated-measures design, 40 subjects randomly received either a combination IAN block (2% lidocaine [100,000 epi]) + IO injection (on the distal of the first molar) using 1.8 ml of 2% lidocalne (1:100,000 epi) or an IAN block (2 % lidocaine [1:100,000 epi]) + mock IO injection (gingival penetration only) at two successive appointments. The first molar and contralateral canine (+ & - controls) were blindly tested with an Analytic Technology pulp tester at 2 min cycles for 60 min. Anesthetic success was defined as no subject response to the maximum output of the pulp tester (80 reading) within 15 rains and maintenance of this reading for 60 mins. One hundred percent of all subjects had lip numbness. Anesthetic success and failure were statistically significant (p<0.05), as analyzed by McNemar tests, between the IAN (42% S, 32% F) and IAN + IO (90% S, 0% F). For the IAN + IO injection, onset was immediate and 80% of subjects sampled felt an increase in heart rate. We concluded that adding the IO injection to an IAN block significantly increased anesthetic success in the first molar. This study was supported by the Graduate Students Research Fund, Dept. of Endodontics.
Anesthetic Efficacy of Intraosseous Injection In Maxillary and Mandibular Teeth. R. COGGINS*, A. READER, R. NIST, M. BECK, W. MEYERS. The Ohio State University, Columbus, OH The purpose of this study was to determine the anestheti,,~ efficacy of the intraosseous injection (IO), using the Stabident ~ system, as a primary technique in human 1st molars and lateral incisors. Forty subjects received two sets of IO injections (on the distal of each experimental tooth), using 1.8 ml of 2% lidocaine (1:100,000 epi.), at two successive appointments. The experimental teeth consisted of 40 maxillary and mandibular 1st molars and lateral incisors. Each experimental tooth and contralateral canine (+ & - controls) were blindly tested with an Analytic Technology pulp tester at 4 rain cycles for 60 min. Anesthetic success was defined as no subject response to the maximum output of the pulp tester (80 reading). Anesthetic success occurred in: 75% of mandibular 1st molars; in 93% of maxillary 1st molars; in 90% of maxillary lateral incisors; in 78% of mandibular lateral incisors. For the IO injection: onset was immediate; the duration steadily decreased over the 60 min; there was a 78 % incidence of subjective increase in heart rate; there was a low incidence (< 15%) of moderate pain with perforation and solution deposition; and 3% of subjects had slow healing perforation sites. We concluded that the IO injection as a primary technique offers few advantages to a ~tandard infiltration and/or nerve block. This study was supported by the Graduate Students Research Fund, Dept. of Endodontics.
Residual Endotoxin on Endodontic Files After Routine Infection Control Procedures. K.W. Tittle*, J.D. Kettering, M.TorabineJad. Loma Linda University, Loma Linda, California. Endotoxin present in the infected canals of teeth is relatively heat stable and unaffected by conventional autoclaving. This study examined the efficacy of current sterilization techniques on endotoxin contaminated endodontic files. Sixty-four files were divided into eight groups of eight each. Files in group I were not contaminated and received no treatment (- controls). Groups II through IV were contaminated with E. coil endotoxin (5pg/ml) and were treated as follows: Group II (+ control) received no treatment. Files in group III were autoclaved. Files in group IV were cleaned in an ultrasonic bath (10 min) then autoclaved. Files in groups V and VI were not contaminated and were treated as groups Ill and IV. Files in group VII and VIII were contaminated with a culture of E. coil and autoclaved. Files in group VIII were then immersed in 5.25% NaOCI for ten seconds. Presence of endotoxin was measured with the Limulus Amebocyte Lysate Chromogenic test. Data was analyzed by individual t-tests. Cleaning files in an ultrasonic bath plus autoclaving completely eliminated measurable endotoxin. The average amount of endotoxin present on each file after culture contamination and autoclaving was 922 Eu. The results show that autoclaving and immersion in NaOCI siqnificantl¥ reduce (p<.001), but do not eliminate endotoxin from contaminated endodontic files.
501
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