牙周韧带注射对下颌磨牙牙髓麻醉效果的临床观察

Anesthetic effect on mandibular permanent molar by periodontal ligament injection using single tooth anesthetic delivery system

目的观察单颗牙麻醉(single tooth anesthesia,STA)系统对下颌磨牙进行牙周韧带(periodontal liga-ment,PDL)注射后的牙髓麻醉效果。方法 120颗患牙分为深龋、慢性牙髓炎、急性牙髓炎3组,每组各40颗。每组再按照随机原则平均分为2个亚组,分别采用STA系统标准法和改良法麻醉,其中标准法注射点为舌侧PDL,改良法注射点为颊侧PDL。观察记录患者治疗中的疼痛反应,评价牙髓麻醉效果。结果 STA系统对下颌磨牙进行PDL注射后牙髓麻醉的总有效率为92.5%。深龋组标准法和改良法的牙髓麻醉有效率均为100%;慢性牙髓炎组标准法和改良法的牙髓麻醉有效率均为90%;急性牙髓炎组标准法的牙髓麻醉有效率为85%,改良法的牙髓麻醉有效率为90%。3组麻醉效果的卡方检验显示,各组间的牙髓麻醉效果差异均无统计学意义(χ2=9.445,P=0.49)。结论无论标准舌侧PDL注射还是改良颊侧PDL注射,只要注射方法正确,都能同样达到满意的麻醉效果。

Objective To assess the anesthetic effect on mandibular permanent molar by periodontal ligament （PI）I,）injection using single tooth anesthetic （STA） delivery system. Methods 120 mandibular permanent molars diagnosised as deep caries, chronic pulpitis and acute pulpitis were randomly divided into two groups. Using STA system, 60 teethreceived PDL injeclion by standard technique, 60 teeth received PDL injection by improved technique. After anesthetic injection, cavity filling treatment or root canal therapy was performed. Anesthetic： effectiveness according to pain senseduring treatment period was recorded. Results The anesthetic： effect rate on mandibular permanet molars was 92.5%. In deep caries group, the anesthetic effect rate was 100.0%. In chronic pulpitis group, the anesthetic effective rate was90%. In acute pulpitis group, the anesthetic effect rate was 85% injected by standard technique and 90% injected by im- proved technique respectively. There was no significant statistic difference between standard and improved technique（X^2= 9. 445,P =0.49）. Conclusion It is a satisfied approach to use either standard or improved technique in PDL injection with STA system in mandibular permanent molar anesthesia.