• Title/Summary/Keyword: Local anesthetic needle fracture

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Physical, chemical, mechanical, and micromorphological characterization of dental needles

  • de Oliveira Monteiro, Marco Antonio;Antunes, Alberto Nogueira da Gama;Basting, Roberta Tarkany
    • Journal of Dental Anesthesia and Pain Medicine
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    • v.21 no.2
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    • pp.139-153
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    • 2021
  • Background: In anesthetic techniques, touching bones can cause needle bending. Theoretically, a needle should support such deflection without fracturing. However, it is possible that a needle may fracture depending on the quality and type of needle used. This study evaluated the physical, chemical, and micromorphological characteristics of long and short dental anesthetic needles, as well as the mechanical properties of flexural load and bending resistance when needles are subjected to different bending angles. Methods: Long and short needles (30G, Jets, Misawa, Selekto, Terumo, Unoject and 27G, Dencojet, Injex, Jets, Misawa, Procare, Setoject XL, Terumo) were evaluated. Scanning electron microscopy was used to evaluate the needle bevels and energy-dispersive X-ray spectroscopy was used for the chemical analysis of needle compositions. Flexural loading and bending strength assessments were performed using a universal testing machine by bending the needles (n = 5) to angles of 30°, 60°, or 90°, or until fracture occurred. Results: The Injex 27G, Jets 27G, and Septoject XL 27G needles were all less than 30 mm in length. There were small percentage variations in the chemical compositions of the needles. Superior smoothness was observed for the Unoject 30G needle, which exhibited the highest fracture resistance at 60°. The Jets 30G needle exhibited greater resistance to fractures at 90°. The Procare 27G needle exhibited the highest load resistance to bending, followed by the Septoject XL 27G needle, and both needles were tied for the lowest fracture resistance. No needle fractured when bent to 30° or at less than three bends to 60° or 90°. Conclusions: Greater needle resistance to bending increases the probability of early fracturing. Thinner and shorter needles are more resistant than longer and thicker needles. Performing a single bend does not result in any significant risk of fracture or obliterate the lumen, allowing for the continued passage of anesthetic liquid.

Removal of a broken needle using three-dimensional computed tomography: a case report

  • Kim, Jin-Ha;Moon, Seong-Yong
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.39 no.5
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    • pp.251-253
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    • 2013
  • Inferior alveolar nerve block obtained maximum anesthetic effect using a small dose of local anesthetic agent, which also has low a complication incidence. Complications of an inferior alveolar nerve block include direct nerve damage, bleeding, trismus, temporary facial nerve palsy, and etc. Among them, the major iatrogenic complication is dental needle fracture. A fragment that disappears into the soft tissue would be hard to remove, giving rise to a legal problem. A 31-year-old woman was referred for the removal of a broken needle, following an inferior alveolar nerve block. Management involved the removal of the needle under local anesthesia with pre- and peri-operative computed tomography scans.

하치조신경 전달마취 중 파절된 주사바늘

  • Jang, Jung-Hui;Song, Min-Seok;Kim, Hyeon-Min;Kim, Nam-Hun;Eom, Min-Yong;Koo, Hyun-Mo;Yi, Jun-Kyu;Yang, Byeong-Eon
    • The Journal of the Korean dental association
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    • v.44 no.2 s.441
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    • pp.139-144
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    • 2006
  • Local anesthesia is routine procedure in dental practices and has several complication. One of them, needle fracture is not uncommon in past, but rare in recent. The number of cases reported in the literature of broken needle in local anesthetic procedure has shown a marked decrease since the use of disposable spiral-constructed dental needle began. This complication results from lack of patient cooperation, inaccurate anesthetic technique, sudden movement of patient, error in the manufacturing procedure, use of short needle, and bending before use. Most common site is pterygomandibular space during inf. alveolar nerve block. In two patients, we removed broken needles under general anesthesia without complication. So we report cases with review of literatures.

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Fracture of a Dental Needle during Inferior Alveolar Nerve Block in a Young Child: A Case Report (어린 아동의 하치조신경 전달마취 시 발생한 주사바늘 파절 : 증례보고)

  • Lee, Hanbyeol;Kim, Minkeun;Park, Howon;Seo, Hyunwoo;Lee, Juhyun
    • Journal of the korean academy of Pediatric Dentistry
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    • v.43 no.3
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    • pp.320-326
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    • 2016
  • The fracture of a needle during local anesthesia in dental treatment is rare; however, when it occurs, the needle should be removed without damage to surrounding structures as soon as possible. A fractured needle fragment that is buried in soft tissue would be difficult to remove, and a careful surgical procedure under general anesthesia is recommended in such cases. Children who require dental treatment are often not capable of cooperative behavior, thus unexpected movements can increase the risk of needle fracture. Clinicians can reduce the incidence of needle fracture accidents with a few precautions. In the present case report, we report a case of needle fracture due to abrupt movement during inferior alveolar nerve block anesthesia in a young child, with the purpose of drawing attention to needle fracture incidents. This report describes the possible causes and prevention methods of local anesthetic needle fracture, and the localization methods and surgical procedure for needle fragment removal.

Radiographic and computed tomography monitoring of a fractured needle fragment in the mandibular branch

  • Villalobos, Maria Isabel de Oliveira e Britto;Leite, Thaisa Cristina Gomes Ferreira;Barra, Samila Goncalves;Werneche, Daniela Teresa Pinto da Cunha;Manzi, Flavio Ricardo;Cardoso, Claudia Assuncao e Alves
    • Imaging Science in Dentistry
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    • v.47 no.1
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    • pp.63-68
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    • 2017
  • Some complications can arise with the usage of local anesthesia for dental procedures, including the fracture of needles in the patient. This is a rare incident, usually caused by the patient's sudden movements during anesthetic block. Its complications are not common, but can include pain, trismus, inflammation in the region, difficulty in swallowing, and migration of the object, which is the least common but has the ability to cause more serious damage to the patient. This report describes a case in which, after the fracture of the anesthetic needle used during alveolar nerve block for exodontia of the left mandibular third molar, the fragment moved significantly in the first 2 months, before stabilizing after the third month of radiographic monitoring.