sábado, 19 de febrero de 2011

Jeringa micro vibrador (SMV) un nuevo dispositivo que se introduce en la odontología para aliviar el dolor y la ansiedad de las inyecciones intraorales, y un estudio comparativo con un dispositivo similar


Jeringa micro vibrador (SMV) un nuevo dispositivo que se introduce en la odontología para aliviar el dolor y la ansiedad de las inyecciones intraorales, y un estudio comparativo con un dispositivo similar.
Syringe micro vibrator (SMV) a new device being introduced in dentistry to alleviate pain and anxiety of intraoral injections, and a comparative study with a similar device.
Shahidi Bonjar AH.
Student of Dentistry, Students Research Committee, School of Dentistry, Shahid Beheshti Medical University, Evin, Tehran 1983963113, Iran.shahidiah@gmail.com.
Ann Surg Innov Res. 2011 Jan 7;5(1):1.
 
Abstract
BACKGROUND: Neurologically, it is proven that stimulation of larger diameter fibers - e.g. using appropriate coldness, warmth, rubbing, pressure or vibration- can close the neural "gate" so that the central perception of itch and pain is reduced. This fact is based upon "Gate-control" theory of Melzack and Wall. PRESENTATION OF THE HYPOTHESIS: Syringe Micro Vibrator is a new design being introduced for the first time in the field of Dentistry. This device is a promising breakthrough in pain and anxiety management and may deliver solution for clinicians plagued with patient pain phobia. It has an off-set rotating micro vibration creator with ultra high frequency and ultra low altitude that can be easily placed on any standard dental syringe and some disposable syringes. This device was registered as an invention in dentistry and received Iran National Patent number of 63765. TESTING THE HYPOTHESIS: By creating micro vibration, this device would be effective in reducing the pain and anxiety confronted with most types of intraoral injections as palatal, mandibular block, intraligamental and local infiltration. From the aspect of the patient pain management, this device contributes both physiologically (based on Gate Control Theory of pain) and psychologically (based on the device function as will be explained by dentist to the patient as a modern pain reducing technology). From the aspect of clinician, SMV motor provides vibrations with ultra high frequency to alleviate pain, but since it has ultra low vibration altitude, it has no adverse effect on the clinician dexterity and accuracy during injection and it does not interfere with pin point localization of injection site. IMPLICATIONS OF THE HYPOTHESIS: Upon mounting on a conventional dental anesthesia injection syringe, SMV is switched on and the clinician then uses normal injection technique to administer the anesthetic. This device is not only a useful accessory device for ordinary patients, but also more useful for pediatric patients and those who have a phobia of intraoral injection or pain
 
Enlace para bajar el artículo en PDF


  
El efecto de la anestesia local en la calidad de las características de recuperación después de la rehabilitación dental bajo anestesia general en niños
The effect of local anesthetic on quality of recovery characteristics following dental rehabilitation under general anesthesia in children.
Townsend JA, Ganzberg S, Thikkurissy S.
LSU School of Dentistry, Department of Pediatric Dentistry, New Orleans, Louisiana 70119, USA. jtown2@lsuhsc.edu
Anesth Prog. 2009 Winter;56(4):115-22. 
Abstract
This study is a randomized, prospective, double-blind study to evaluate the effects of the combination of local anesthetics and an intravenous nonsteroidal anti-inflammatory drug (NSAID) vs NSAID alone on quality of recovery following dental rehabilitation under general anesthesia (GA). Twenty-seven healthy children aged 3-5.5 years underwent dental rehabilitation under GA. Fifteen children in the experimental group received oral infiltration of local anesthetic in addition to intravenous ketorolac tromethamine, while 12 children in the control group received intravenous ketorolac tromethamine alone for postoperative pain management. Pain behaviors were evaluated immediately postoperatively using a FLACC scale and 4 hours postoperatively by self-report using various scales. Parents reported perception of child pain and comfort and any occurrences of postoperative cheek biting. The use of intraoral infiltration local anesthesia for complete dental rehabilitation under general anesthesia for children aged 3-5.5 years did not result in improved pain behaviors in the postanesthesia care unit (PACU), nor did it result in improved pain behaviors 4-6 hours postoperatively as measured by the FLACC scale, FACES scale, and subjective reports of parents or a PACU nurse. Those children receiving local anesthesia had a higher incidence of negative symptoms related to local anesthetic administration, including a higher incidence of lip and cheek biting, which was of clinical importance, but not statistically significant. Infiltration of local anesthetic for dental rehabilitation under general anesthesia did not improve quality of recovery in children aged 3-5.5 years.

Enlace para bajar el artículo en PDF

Un ensayo controlado aleatorio que compara técnicas  de anestesia mandibular local en niños que recibieron sedación con óxido nitroso y oxígeno
A randomized controlled trial comparing mandibular local anesthesia techniques in children receiving nitrous oxide-oxygen sedation.
Naidu S, Loughlin P, Coldwell SE, Noonan CJ, Milgrom P.
Department of Dental Public Health Sciences, University of Washington, Seattle, Washington 98195-7475, USA.
Anesth Prog. 2004;51(1):19-23. 
Abstract
The aim of this study was to test the hypothesis that dental pain control using infiltration/intrapapillary injection was less effective than inferior alveolar block/long buccal infiltration anesthesia in children. A total of 101 healthy children, aged 5-8 years, who had no contraindication for local anesthetic and who needed a pulpotomy treatment and stainless steel crown placement in a lower primary molar were studied. A 2-group randomized blinded controlled design was employed comparing the 2 local anesthesia techniques using 2% lidocaine, 1:100,000 epinephrine. All children were given 40% nitrous oxide. Children self-reported pain using the Color Analogue Scale. The study was conducted in a private pediatric dental practice in Mount Vernon, Wash. Overall pain levels reported by the children were low, and there were no differences between conditions at any point in the procedure. Pain reports for clamp placement were block/long buccal 2.8 and infiltration/intrapapillary 1.9 (P = .1). Pain reports for drilling were block/long buccal 2.0 and infiltration/intrapapillary 1.8 (P = .7). Nine percent of children required supplementary local anesthetic: 4 of 52 (7.7%) in the block/long buccal group and 5 of 49 (10.2%) in the infiltration/intrapapillary group (P = .07). The hypothesis that block/long buccal would be more effective than infiltration/intrapapillary was not supported. There was no difference in pain control effectiveness between infiltration/intrapapillary injection and inferior alveolar block/long buccal infiltration using 2% lidocaine with 1:100,000 epinephrine when mandibular primary molars received pulpotomy treatment and stainless steel crowns.

Enlace para bajar el artículo en PDF

No hay comentarios: