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Combined inferior alveolar nerve block anaesthesia and local infiltration anaesthesia in extraction of impacted mandibular third molars: a randomised controlled trial

British Dental Journal (2020)Cite this article

Abstract

Aim To compare the anaesthetic effect of combination of inferior alveolar nerve block anaesthesia and local infiltration anaesthesia with nerve block anaesthesia techniques in the extraction of mandibular third molars.

Materials and methods One hundred and fifty healthy adult volunteers were divided into three groups and were administered three different local anaesthetic techniques before tooth extractions: group A (inferior alveolar nerve, lingual nerve and buccal nerve block anaesthesia with lidocaine), group B (inferior alveolar nerve, lingual nerve and buccal nerve block anaesthesia with mepivacaine) and group C (inferior alveolar nerve block anaesthesia with lidocaine and infiltration anaesthesia with mepivacaine). The patients' reported pain on anaesthesia injection and tooth extraction, the surgeon's assessment of anaesthetic effect, the severity of intra-operative bleeding and post-operative complications were evaluated.

Results There was no significant difference in visual analogue scale (VAS)-pain of anaesthesia among the three groups. Compared with groups A and B, group C had reduced VAS-pain of tooth extraction scores. Additionally, the surgeon's assessment of anaesthetic effect improved and intra-operative bleeding decreased.

Conclusions The combination of inferior alveolar nerve block and infiltration anaesthesia provides a stronger anaesthetic effect in the extraction of mandibular third molars.

Key points

  • Improvement of painless dental treatment.

  • Compared to conventional inferior alveolar nerve block, combined anaesthesia improves the anaesthetic effect in the extraction of the mandibular third molar.

  • The application of combination of inferior alveolar nerve block anaesthesia and local infiltration anaesthesia in the extraction of mandibular molars is worth promoting in the clinic.

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Acknowledgements

The present study was supported by special fund for high-level university construction talents of Guangzhou Medical University (B185006003006). Ethics approval: this study was approved by Stomatology Hospital of Guangzhou Medical University IRB (No. KY2019037) and all participants signed an informed consent agreement. Patients were given the option to opt out of this study online. None of the subjects declined to participate. No individual person's data in any form were involved in this study.

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Authors and Affiliations

  1. Department of Oral and Maxillofacial Surgery, Affiliated Stomatology Hospital of Guangzhou Medical University, Guangzhou Key Laboratory of Basic and Applied Research of Oral Regenerative Medicine, Guangzhou, Guangdong 510182, China

    Zhicong Li, Mi Yang, Ting Liao, Yang Zhou, Haiqiong Yue, Zhengguo Piao & Libin Zhou

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  1. Zhicong Li
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  2. Mi Yang
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  4. Yang Zhou
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  6. Zhengguo Piao
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  7. Libin Zhou
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Contributions

ZCL organised and conducted this study. MY, TL, YZ, HQY and ZGP assisted with this study (collected the study data). LBZ conceived the idea, designed the experiments and analysed the data. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Libin Zhou.

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The authors have no potential conflicts of interest to declare.

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Li, Z., Yang, M., Liao, T. et al. Combined inferior alveolar nerve block anaesthesia and local infiltration anaesthesia in extraction of impacted mandibular third molars: a randomised controlled trial. Br Dent J (2020). https://doi.org/10.1038/s41415-020-2002-z

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