Journal of Dental Anesthesia and Pain Medicine

The Korean Dental Society of Anesthsiology (대한치과마취과학회)
권호 표지
DOI QR코드

DOI QR Code

Computed tomography-guided 3D printed patient-specific regional anesthesia

  • Jundt, Jonathon S. (Department of Oral and Maxillofacial Surgery, The University of Texas) ;
  • Chow, Christopher C. (Department of Oral and Maxillofacial Surgery, The University of Texas) ;
  • Couey, Marcus (Head and Neck Oncologic and Microvascular Reconstructive Surgery, Providence Cancer Institute)
  • Received : 2020.06.10
  • Accepted : 2020.08.27
  • Published : 2020.10.31
Download PDF
⟨ Previous Next ⟩

Abstract

Classic anesthetic techniques for the inferior alveolar nerve, lingual nerve, and long buccal nerve blockade are achieved by estimating the intended location for anesthetic deposition based on palpation, inspection, and subsequent correlation for oral anatomical structures. The present article utilizes computed tomography (CT) data to 3D print a guide for repeatable and accurate deposition of a local anesthetic at the ideal location. This technical report aims to anatomically define the ideal location for local anesthetic deposition. This process has the potential to reduce patient discomfort, risk of nerve damage, and failed mandibular anesthesia, as well as to reduce the total anesthetic dose. Lastly, as robotic-based interventions improve, this provides the initial framework for robot-guided regional anesthesia administration in the oral cavity.

Keywords

References

  1. Thangavelu K, Kannan R, Kumar NS, RethishnE, Sabitha S, Sayeeganesh N. Significance of localization of mandibular foramen in an inferior alveolar nerve block. J Nat Sci Biol Med 2012; 3: 156-60. https://doi.org/10.4103/0976-9668.101896
  2. Ravi Kiran BS, Kashyap VM, Uppada UK, Tiwari P, Mishra A, Sachdeva A. Comparison of efficacy of halstead, vazirani akinosi and gow gates techniques for mandibular anesthesia. J Maxillofac Oral Surg 2018; 17: 570-5. https://doi.org/10.1007/s12663-018-1092-5
  3. Kang SH, Byun IY, Kim JH, Park HK, Kim MK. Three-dimensional anatomic analysis of mandibular foramen with mandibular anatomic landmarks for inferior alveolar nerve block anesthesia. Oral Surg Oral Med Oral Pathol Oral Radiol 2013; 115: e17-23. https://doi.org/10.1016/j.oooo.2011.10.038
  4. Malamed S. Handbook of Local Anesthesia. 6th ed. Mayland heights, Mosby. 2012, pp.157-253.
  5. Blacher J, Van DaHuvel S, Parashar V, Mitchell JC. Variation in location of the mandibular foramen/inferior alveolar nerve complex given anatomic landmarks using cone-beam computer tomographic scans. J Endod 2016; 42: 393-6. https://doi.org/10.1016/j.joen.2015.12.009
  6. Al-Shayyab MH. A simple method to locate mandibular foramen with cone-beam computed tomography and its relevance to oral and maxillofacial surgery: a radioanatomical study. Surg Radiol Anat Surg Radiol Anat 2018; 40: 625-34. https://doi.org/10.1007/s00276-018-2015-3
  7. Nicholson ML. A study of the position of the mandibular foramen in the adult human mandible. Anat Rec 1985; 212: 110-2. https://doi.org/10.1002/ar.1092120116
  8. Hwang TJ, Hsu SC, Huang QF, Guo MK. Age changes in location of mandibular foramen. Zhonghua Ya Yi Xue Hui Za Zhi 1990; 9: 98-103.
  9. Chung MT, Levi B, Hyun JS, Lo DD, Montoro DT, Lisiecki J, et al. Pierre Robin sequence and Treacher Collins hypoplastic mandible comparison using three-dimensional morphometric analysis. J Craniofac Surg 2012; 23: 1959-63.
  10. Sakamoto Y, Akita K. Spatial relationships between masticatory muscles and their innervating nerves in man with special reference to the medial pterygoid muscle and accessory muscle bundle. Surg Radiol Anat 2004; 26: 122-7. https://doi.org/10.1007/s00276-003-0177-z
  11. Stein P, Brueckner J, Milliner M. Sensory innervation of mandibular teeth by the nerve to the mylohyoid: implications in local anesthesia. Clin Anat 2007; 20: 591-5. https://doi.org/10.1002/ca.20479
  12. Kim SY, Hu KS, Chung IH, Lee EW, Kim HJ. Topographic anatomy of the lingual nerve and variation in communication pattern of the mandibular nerve branches. Surg Radiol Anat 2004; 26: 128-35. https://doi.org/10.1007/s00276-003-0179-x
  13. Smith MH, and Lung KE. Nerve injuries after dental injection: a review of the literature. J Can Dent Assoc 2006; 72: 559-64.
  14. Pogrel MA, Thamby S. Permanent nerve involvement resulting: from inferior alveolar nerve blocks. J Am Dent Assoc 2000; 131: 901-7. https://doi.org/10.14219/jada.archive.2000.0308
  15. Boynes SG, Echeverria Z, Abdulwahab M. Ocular complications associated with local anesthesia administration in dentistry. Dent Clin North Am 2010; 54: 677-86. https://doi.org/10.1016/j.cden.2010.06.008
  16. Leventhal D, Schwartz DN. Infratemporal fossa abscess: complication of dental injection. Arch Otolaryngol Head Neck Surg 2008; 134: 551-3. https://doi.org/10.1001/archotol.134.5.551
  17. Won YJ, Kang SH. Application of augmented reality for inferior alveolar nerve block anesthesia: a technical note. J Dent Anesth Pain Med 2017; 17: 129-34. https://doi.org/10.17245/jdapm.2017.17.2.129
  18. Li G. Patient radiation dose and protection from cone-beam computed tomography. Imaging Sci Dent 2013; 43: 63-9. https://doi.org/10.5624/isd.2013.43.2.63