جستجوی مقالات مرتبط با کلیدواژه « mandibular nerve » در نشریات گروه « پزشکی »

Successful management of pain during endodontic treatment is essential for both patients and dentists. Achieving adequate pulp anesthesia in mandibular molars is a significant concern for patients with irreversible pulpitis during endodontic treatment. The increased sensitization of nociceptors due to inflammation decreases the success of inferior alveolar nerve block (IANB). The main focus is on reducing inflammation before delivery of local anesthesia to increase the success of anesthetic drugs. This umbrella review aimed to revise, qualify and summarize the existing body of evidence on the effect of premedication on IANB in patients with irreversible pulpitis. A literature search was conducted using electronic databases (PubMed, Scopus, the Web of Science, and the Cochrane Library) with no date restriction until September 2021 to identify the relevant studies. All the cross‑references of the selected studies and grey literature were also screened. Four systematic reviews assessing the effect of premedication on the success of IANB were selected. A conclusion was drawn that premedication with >400 mg of ibuprofen can positively affect the success of IANB.

The aim of this study was to evaluate the prevalence and anatomical variations of retromolar canal (RMC). Since RMC contains neurovascular bundle that contribute to the innervation and nutrition of the pulp and periodontium of the mandibular teeth, it is necessary to pay attention to the clinical importance of this landmark, to prevent possible surgical complications and anesthetic failures.

In this descriptive-analytical study, 450 CBCT scans were evaluated. The scans were evaluated for presence of the RMC and linear measurements (distance to second and third molar, height, width and diameter) were made with NNT software. Descriptive statistics were used to assess data. Data were analyzed using paired t-test adopting significance for p value ≤0.05.

The prevalence of RMC was 7.1%. Among of the existed RMC, 71.9% were unilateral and 28.1% were bilateral. The mean height of canal was 9.33 ± 3.65 mm, and the mean width of the canal was 0.87 ± 0.4 mm. The mean distance of RMC to the third and second molar were 10.44 ± 5.1 mm and 11.71 ± 3.73 mm respectively. No significant differences were detected between the two genders.

The prevalence of the RMC was observed to be 7.1% and was well observed in CBCT images. Accurate assessment of this anatomic landmark helps prevent surgical complications especially prior to third molar anesthesia and extraction.

Achieving adequate pulpal anesthesia could be challenging in mandibular molars. There are some disagreements about the success rate of local infiltration anesthesia with articaine as primary injection. Therefore, the aim of this study was to assess the efficacy of 4% articaine lingual subperiosteal injection as the primary injection for permanent mandibular second molars in comparison with inferior alveolar nerve block (IANB).  

Fifteen healthy adult volunteers participated in this study. A randomized, split-mouth, single-blind design was used to allocate each side of the mandible in each patient to the test or control group. On the test side, lingual subperiosteal injection with 4% articaine and 1:100,000 epinephrine wasperformed for the mandibular second molar; whereas, in the control group, an IANB with 2% lidocaine and 1:80,000 epinephrine was administered. Electric pulp testing was done at baseline, and also at 5, 8, 11, 15, 20, 25, 30, 45, 60, 75, and 90 minutes after injection. Statistical analysis was carried out using t-test and Chi-square test.

The success rate of IANB was significantly higher than that of lingual subperiosteal injection (P=0.0001). The difference in the onset of action between the two groups was significant (P<0.05). Anesthesia duration was 61.0±28.0 minutes in IANB group and 10.2±12.4 minutes in lingual subperiosteal injection group, with a significant difference between them (P<0.01).

IANB with 2% lidocaine is preferable to 4% articaine lingual subperiosteal injection due to its superior success rate, faster onset of action, and longer duration of effect.

Statement of the Problem:

The inferior alveolar canal (IAC) is a bony canal that starts from mandibular foramen at the inner surface of the mandibular ramus and extends along the ramus and body of mandibular bone in forward and downward directions to the mental foramen. Inside the mandibular canal, there are lower alveolar artery and a nerve with the same name. Understanding the anatomical details of the lower alveolar canal, including position, pathway and morphology to prevent complications in surgical procedures in the lower jaw such as mandibular impacted molar surgeries, mandibular nerve block injection, or even root canal treatment of mandibular teeth is important.

The purpose of this study was to investigate the course and direction of IAC in mandibular bone and its relation to anatomical factors such as gonial angle and location of entrance of IAC in the mandibular ramus.

This cross-sectional study evaluated a sample of 280 digital panoramic images. All samples were Iranian. The pattern and direction of the IACs were recorded according to age and gender and the relation of these patterns to the gonial angle of mandible and the entry point of the IAC in mandibular ramus were evaluated.

The results showed that the course of canal, the entrance point of the canal and the gonial angle were the same between different age groups and between two genders. There was no significant relation between the course of canal and the two anatomical variables mentioned (p> 0.05).

Considering the increasing frequency of implant surgeries and presence of different courses of the mandibular canal and concerning the important complications such as paresthesia caused by damage to the mandibular nerve, panoramic radiography is necessary before any surgery in this area to avoid unwanted injuries to the neurovascular system if other advanced modalities are not available.

Patients with tooth loss in the posterior mandible,requiring dental implantation, mayalso require other simultaneous surgical procedures due to severe atrophy, such as nerve lateralization. However, it is difficult to achieve the appropriate width and height in this area in patients with atrophic ridges. In the present case, we performed inferior alveolar nerve (IAN) repositioning and iliac bone grafting simultaneously to achieve satisfactory width and height in an edentulous adult patient with insufficient bone height and width in the posterior mandible. The follow-up did not indicateany nerve damage, anda significant increase was observed in the bone height, which facilitated successful implantation. This study showed the feasibility of IAN repositioning withsimultaneous iliac bone autogenous grafting for thetreatment of atrophic posterior mandibular ridges. However, further studies are required to confirm the safety and efficacy of this combinational method. Keywords: Alveolar bone loss; Mandibular nerve; Nerve repositioning; Iliac bone; Autografts.

Effective pain control is a prerequisite for successful child dental treatment.This study was designed to evaluate the efficacy of tactile versus visual method to define needle insertion point of IANB for pulpotomy in children.

In this double-Blind, cross-over, randomized clinical trial, 40 children (7-9 years old) requiring primary mandibular second molars pulpotomy were recruited. Study was performed in Zahedan Dental School at 2016. Children were randomly divided into two groups. Group I received IANB using tactile method in the right side in the first session, and using visual method in the left side in the second session. Group II received the visual method for the right and the tactile method for the left in two sessions respectively. Objective and subjective pains during injection were recorded using SEM and FIS, respectively. Reaction during cavity preparation; recorded by SEM, was evaluated as sign of anesthesia failure. Data were analyzed using the Mann-Whitney U, Wilcoxon Singed Rank and Fisher's Exact Tests at a significance level of 0.05. 

Regarding tactile method, comparing groups I and II showed no significant difference in any of the variables (P> 0.05). About visual method two groups showed a significant difference only in subjective pain (P= 0.013). In group I, visual method showed significant differences in objective and subjective pain versus tactile method (p < 0.05). In group II, no significant differences were found between the two methods in variables. Totally, all variables were significantly different in favor of visual method versus tactile method (p <0.05).

The visual method reduced objective and subjective pain and yielded superior anesthesia success compared to tactile method.

Ultrasound-guided nerve blocks have enhanced our abilities to selectively and effectively suppress certain nerves to accomplish specific goals, including blockade a localized seizure muscle movement without affecting the seizure threshold or level of the consciousness.

This is a case report of the blockade of the movement of a chewing muscle by the continuous (catheter-based) mandibular nerve block in a 27 years old man with high-frequency partial seizures in facial muscles who was a candidate for seizure focus ablation. An out-of-plane approach was used to insert a catheter near the mandibular nerve to provide intermittent or continuous peripheral nerve block. This report demonstrated that a continuous block of the mandibular nerve could effectively facilitate the seizure focus mapping and ablation.

We can selectively suppress the contractures of a certain muscle in partial seizures by a continuous block of the responsible nerve. This blockade can facilitate seizure focus mapping and ablation.

Accurate localization of the inferior alveolar canal (IAC) is extremely important in some dental treatments. Anatomical variation of the canal means that it can be difficult to locate. The purpose of this study was to assess the relationship of the gonial angle (GA) size and IAC position using cone beam computed tomography (CBCT).

In this in vitro study, 61 dry adult human hemi-mandibles were used. The CBCT scans were taken of all samples and GA was measured on all CBCT scans. The samples were divided into two groups of low angle (≤125°) and high angle (>125°). The canal dimensions, length and course were evaluated. On the sagittal view, the IAC path was classified as type A, B or C. On the axial view, canal course was defined as A1 or A2 according to the mental foramen angle.

The average GA size was 121.8±7.05° at the right side and 123.8±6.32° at the left side. On the sagittal view, there was a significant correlation between the GA size and the canal course (P=0.04). In the high-angle group, type A was dominant; whereas in the low-angle group, type B was more common. On the axial view of IAC course, type A1 was more common (73.43%).

The results showed that GA size was associated with IAC course. In cases with a larger GA, the canal runs in a more straightforward path, and at the same level as the mental foramen.