• Title/Summary/Keyword: Dental Anesthesia device

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Effectiveness of an extraoral cold and vibrating device in reducing pain perception during deposition of local anesthesia in pediatric patients aged 3-12 years: a split-mouth crossover study

  • Ashveeta Shetty;Shilpa S Naik;Rucha Bhise Patil;Parnaja Sanjay Valke;Sonal Mali;Diksha Patil
    • Journal of Dental Anesthesia and Pain Medicine
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    • v.23 no.6
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    • pp.317-325
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    • 2023
  • Background: Local anesthetic injections may induce pain in children, leading to fear and anxiety during subsequent visits. Among the various approaches recommended to reduce pain, one is the use of a Buzzy BeeTM device that operates on the concept of gate control theory and distraction. The literature regarding its effectiveness during the deposition of local anesthesia remains limited; hence, the aim of the present study was to determine the efficacy of extraoral cold and vibrating devices in reducing pain perception during the deposition of local anesthesia. Methods: A split-mouth crossover study in which 40 children aged 3-12 years requiring maxillary infiltration or inferior alveolar nerve block for extractions or pulp therapy in the maxillary or mandibular posterior teeth were included. The control intervention involved the application of topical anesthetic gel for one minute (5% lignocaine gel), followed by the administration of local anesthetic (2% lignocaine with 1:80,000 adrenaline) at a rate of 1 ml/ minute. Along with the control protocol, the test intervention involved using the Buzzy BeeTM device for 2 minutes before and during the deposition of the local anesthetic injection. The heart rate and face, legs, arms, cry, and consolability revised (FLACC-R) scale scores were recorded by the dentist to assess the child's pain perception. Results: The mean age of the participants in Group A and Group B was 7.050 ± 3.12 years and 7.9 ± 2.65 years respectively. A reduction in the mean heart rate and FLACC-R score was observed during the deposition of local anesthetic solution in the tissues when the Buzzy BeeTM was used in both groups at different visits in the same subjects (P < 0.05) The Buzzy BeeTM device was effective in reducing the heart rate and FLACC-R scores when used during maxillary infiltration and inferior alveolar nerve block local anesthesia techniques (P < 0.05). Conclusion: The use of extraoral cold and vibrating devices significantly reduces pain perception during local anesthetic deposition in pediatric patients. Considering the results of this study, the device may be incorporated as an adjunct in routine dental practice while administering local anesthesia in children.

Protective dental splint for oroendotracheal intubation: experience of 202 cases

  • Lee, Kang-Hee;You, Tae-Min;Park, Wonse;Lee, Sun Hwa;Jung, Bock-Young;Pang, Nan-Sim;Kim, Kee-Deog
    • Journal of Dental Anesthesia and Pain Medicine
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    • v.15 no.1
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    • pp.17-23
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    • 2015
  • Background: Dental injury as a result of oroendotracheal intubation during general anesthesia is very common. We report our experiences of using mouthguard to prevent dental injury during intubation based on our protocol. Methods: This retrospective study enrolled patients referred for preanesthetic evaluation, those patients with a history of any of the dental treatments to their anterior teeth listed on our fabrication protocol from January 1, 2009 to June 30, 2010. Results: No cases of dental trauma during oroendotracheal intubation were reported among the 202 patients who used a protective device. 66% of the patients had risk factors for hard tissue damage aged 10-40 years. At the ages of 40-70 years, the incidence of risk group for periodontal damage was higher. Conclusions: Preanesthetic consultation was effective for preventing dental injury, so preanesthetic questionnaire and proper dental consultation would be helpful.

Circadian variation of IV PCA use in patients after orthognathic surgery - a retrospective comparative study

  • Park, Sookyung;Chi, Seong In;Seo, Kwang-Suk;Kim, Hyun Jeong
    • Journal of Dental Anesthesia and Pain Medicine
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    • v.15 no.3
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    • pp.141-146
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    • 2015
  • Background: An understanding of the features of postoperative pain is essential for optimal analgesic dosing strategies. Using a visual analogue scale (VAS) score and patient controlled analgesia (PCA) infusion pattern analysis, an anesthesiologist can estimate when and how severely patients suffer from pain. Several reports have been published about circadian changes in the pain threshold. Postoperative pain was analyzed retrospectively in 250 patients who underwent orthognathic surgery. Methods: A total of 250 patients were allocated into two groups according to the time of recovery from anesthesia. Patients in the early group (group E) recovered from anesthesia before 06:00 p.m. Patients in the late group (group L) recovered from anesthesia after 06:00 p.m. All patients received intravenous patient controlled analgesia (IV PCA) at the end of the operation. The VAS score of pain intensity was measured. Self-administration of bolus analgesic from the IV PCA device was also analyzed according to actual time and elapsed time. Results: VAS scores showed no difference between the two groups except 36 hours after recovery from anesthesia. On POD1, there were two peaks for self-administration of bolus analgesics in group L and one peak in the morning for group E. Two peaks each in the morning and in the afternoon were shown in both groups on POD2. Conclusions: Diurnal variance in pain should be considered for effective dosing strategies.

Effectiveness Evaluation of Displacement Accommodatable Pressure Measuring Jig for Quality Assessment of Pressure Application Device (압력 인가 장치의 품질관리를 위한 변위 수용이 가능한 압력 측정용 지그의 유효성 평가)

  • Mun, Chang-Su;Jun, Sung-Chul;Noh, Si-Cheol
    • Journal of the Institute of Convergence Signal Processing
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    • v.21 no.2
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    • pp.61-66
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    • 2020
  • Recently, a variety of electric anesthetics devices have been developed and used in clinical practice to reduce the fatigue of the operator during local anesthesia for dental procedures and to compensate for the disadvantages of manual anesthesia device. In this electric anesthesia injection device, the accurate and constant delivery of pressure for drug infusion is a very important performance factor. In order to evaluate the accuracy of the transfer pressure, a small pressure gauge using a load cell is often used, but since the elastic body inside the load cell may not be able to accommodate a sufficient displacement, an error may occur when evaluating pressure performance. For these reasons, in this study, we proposed and evaluated a silicon-chrome steel (Si-Cr steel) spring jig that can accommodate relatively large displacements that can be used when evaluating the performance of a pressure-controlled pressure application device using a load cell type pressure gauge. As a result of the pressure transmissibility test and repeated measurement results using a commercial dental anesthesia injection device, a more stable result was obtained when using a spring jig, and it was confirmed that the frequency of abnormally high measurement was reduced.

EC50 of Remifentanil to Prevent Propofol Injection Pain

  • Hong, Hun Pyo;Ko, Hyun Min;Yoon, Ji Young;Yoon, Ji Uk;Park, Kun Hyo;Roh, Young Chea
    • Journal of The Korean Dental Society of Anesthesiology
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    • v.13 no.3
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    • pp.89-94
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    • 2013
  • Background: Various strategies have been studied to reduce the propofol injection pain. This study was designed to find out effect-site target concentration (Ce) of remifentanil at which there was a 50% probability of preventing the propofol injection pain (EC50). Methods: Anesthesia was induced with a remifentanil TCI (Minto model). The Ce of remifentanil for the first patient started from 2.0 ng/ml. The Ce of remifentanil for each subsequent patient was determined by the response of the previous patient by Dixon up-and-down method with the interval of 0.5 ng/ml. After the remifentanil reached target concentrations, propofol was administered via a target-controlled infusion system based on a Marsh pharmacokinetic model using a TCI device (Orchestra$^{(R)}$; Fresenius-Vial, Brezins, France). The dose of propofol was effect site target-controlled infusion (TCI) of $3{\mu}g/ml$. Results: The EC50 of remifentanil to prevent the propofol injection pain was $1.80{\pm}0.35ng/ml$ by Dixon's up and down method. Conclusions: The EC50 of remifentanil to blunt the pain responses to propofol injection was $1.80{\pm}0.35ng/ml$ for propofol TCI anesthesia.

The Assessment of Stress of Children under Dental Procedures Using Wrist Watch Type Heart Rate Monitoring Devices - Using New Device for Stress Assessment in Children During Restorative Dental Treatment (손목형 심박수 측정 장치를 이용한 어린이의 치과진료 시 스트레스 평가)

  • Oh, Jungeun;Kim, Jongsoo;Yoo, Seunghoon
    • Journal of the korean academy of Pediatric Dentistry
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    • v.42 no.2
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    • pp.119-125
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    • 2015
  • Dental stress is suggested as a main reason for behavioral problems in dentistry, especially in children. Heart rate is a useful measure of dental stress. The purpose of the present study is to examine the effect of dental stress on children receiving restorative treatment under local anesthesia by using recently introduced a wrist-watch type heart rate monitoring device. Eighteen children with no previous dental experience, who needed dental treatment involving local anesthesia, were included in this study. In each session, heart rate was recorded. The largest increase was observed during local anesthesia and the highest values were recorded during preparation. However, no significant relationship was found between the measurements(p > 0.05). Regarding the number of visits, heart rate on the second session is significantly higher than the first session and the third session(p < 0.05). There was no significant different correlation between the first session and third session(p > 0.05). Based on the present study, children who have no previous dental treatment appeared to be more stressed at the second session and need at least 3 sessions to feel less stressed during dental treatment including dental injection.

Combitube insertion in the situation of acute airway obstruction after extubation in patients underwent two-jaw surgery

  • Choi, Yoon Ji;Park, Sookyung;Chi, Seong-In;Kim, Hyun Jeong;Seo, Kwang-Suk
    • Journal of Dental Anesthesia and Pain Medicine
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    • v.15 no.4
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    • pp.235-239
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    • 2015
  • The Combitube is an emergency airway-maintaining device, which can supply oxygen to dyspneic patients in emergency situations following two-jaw surgery. These patients experience difficulty in opening the mouth or have a partially obstructed airway caused by edema or hematoma in the oral cavity. As such, they cannot maintain the normal airway. The use of a Combitube may be favorable compared to the laryngeal mask airway because it is a thin and relatively resilient tube. A healthy 24-year-old man was dyspneic after extubation. Oxygen saturation fell below 90% despite untying the bimaxillary fixation and ambubagging. The opening of the mouth was narrow; thus, emergency airway maintenance was gained by insertion of a Combitube. The following day, a facial computer tomography revealed that the airway space narrowing was severe compared to its pre-operational state. After the swelling subsided, the patient was successfully extubated without complications.

Intraosseous anesthesia in symptomatic irreversible pulpitis: Impact of bone thickness on perception and duration of pain

  • Nilius, Manfred;Mueller, Charlotte;Nilius, Minou Helene;Haim, Dominik;Leonhardt, Henry;Lauer, Guenter
    • Journal of Dental Anesthesia and Pain Medicine
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    • v.20 no.6
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    • pp.367-375
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    • 2020
  • Background: Intraosseous anesthesia (IO) allows the anesthetic solution to be injected directly into the cancellous bone. The anesthetic solution immediately reaches the periapical region, and thus the axonal area of the nerve, where it can temporarily disable the sodium pump. The effect is felt almost without any time delay, and only a small amount of anesthetic solution is required. Methods: This study aims to investigate the efficacy of IO using the AnestoⓇ device after infiltration anesthesia (IA) and/or inferior alveolar nerve block anesthesia (IANB) failed to work in symptomatic irreversible pulpitis (hot tooth). The 33 patients included in the study were treated additionally with 1.7 ml articaine hydrochloride with 1:100,000 epinephrine hydrochloride (UltracainⓇ D-S, Sanofi-Aventis, Frankfurt, Germany) IO. Results: The electrical pulp test showed that 95.76% of the volunteers reacted positively to the combination of IANB or IA with the IO. In women, the additive IO was effective at 97.22%. In men, the IO led to pain elimination in 94.00% of cases. The duration of the IO was less than a quarter of an hour (13.03 min). The IO worked longer in women than in men (13.61 min vs. 12.33 min). Overall, more than every third tooth that needed trepanation was located in the posterior area of the mandible (36.4%). Treatment of hot teeth in this area was associated with an increased pulse rate and increased residual pain. There was a moderate correlation (Spearman-Rho [IRI] = 0.280) between the Visual Analog Scale (VAS) score and bone density, and a significant correlation (IRI = 0.612) between subjective residual pain and bone width. The IO resulted in a moderate, transient increase in the pulse rate by approximately 20 bpm. This is similar to the temporary increase in heart rate after conventional anesthesia techniques in non-preloaded patients and can be considered clinically irrelevant. Conclusion: IO with the AnestoⓇ device as an extension and deepening of local pain elimination is recommended for the treatment of hot teeth.

A Survey of Guardian's Attitudes toward Behavior Guidance Techniques (행동유도법에 대한 보호자의 인식도 조사)

  • Lim, Hyunsoo;Kim, Misun;Lee, Hyoseol;Choi, Sungchul;Kim, Kwangchul
    • Journal of the korean academy of Pediatric Dentistry
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    • v.44 no.4
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    • pp.427-436
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    • 2017
  • The purpose of this study was to examine guardian's attitudes toward behavior guidance techniques used in pediatric dentistry. In this study, 117 guardians participated and the several behavior guidance techniques being used during actual pediatric dental treatment were explained to the guardians prior to writing a questionnaire. The behavior guidance techniques explained were: tell-show-do, voice control, protective stabilization by device, protective stabilization by staff, nitrous oxide sedation, sedation, and general anesthesia. For analysis, 106 completed survey forms were selected. Tell-show-do was rated as the most acceptable technique, followed (in order of decreasing acceptance) by: voice control; protective stabilization by staff; nitrous oxide sedation; protective stabilization by device; sedation; general anesthesia. Acceptance of each behavior guidance technique was not related to guardian age, gender, patient age, patient gender, patient dental experience, type of visit, and position of doctor. Within the limit of this study, the communicative guidance techniques (tell-show-do, voice control) were more acceptable than advanced behavior guidance techniques (protective stabilization, sedation, general anesthesia). The acceptability of general anesthesia was the lowest. The results of this survey may contribute to maintain optimal dentist - guardians communication in pediatric dentistry.