Local anesthesia in oral and maxillofacial surgery: A review of current opinion

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Abstract

Local anesthesia (LA) is the most important pain management process in oral and maxillofacial surgery. Safe and effective LA not only enable patients to obtain high-quality treatment, but also relieve the anxiety of patients when they come to the clinic. The choices of local anesthetic and injection methods determine the success of LA to a great extent. At present, in most countries or regions, common local anesthetics used in oral and maxillofacial surgery belong to amides and they are injected into patients' body mainly through block or infiltration anesthesia. In addition, the operators' technique level, patient's subjective psychology and anatomical variation of maxillofacial structure also have a strong influence on LA in dental clinic. Due to the existence of above factors, the worldwide success rates of LA in oral and maxillofacial surgery is very different. There are no specific LA methods that ensure 100% successful LA rates. Fortunately, the development of new local anesthetic and injection technology are providing us with new ideas to solve this problem. This review mainly report the new research progress on LA in oral and maxillofacial surgery in recent decades and help clinicians with dental LA operation.

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Most cited references 141

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Dental fear/anxiety and dental behaviour management problems in children and adolescents: a review of prevalence and concomitant psychological factors.

Gunilla Klingberg, Anders Broberg (2007)

The objectives of this article were to examine the literature published from 1982 to 2006 and to evaluate prevalence of dental fear and anxiety (DFA) and dental behaviour management problems (DBMP) in children and adolescents, and their relationships to age, sex, general anxiety, temperament, and general behavioural problems. A broad search of the PubMed database was performed using three combinations of search terms. A large proportion of the identified articles could not be used for the review owing to inadequate endpoints, measures or poor study design. Thirty-two papers of acceptable quality were identified and reviewed. The prevalence of both DFA and DBMP were estimated to 9%, with a decrease in prevalence with age. DFA/DBMP were more frequent in girls. DFA/DBMP were related to general fear and both internalizing and externalizing behavioural problems, although these relationships were not clear-cut. Temperament was related to both DFA and DBMP but with different temperamental characteristics, while general behavioural problems mainly correlated with DBMP. DFA/DBMP are common, and several psychological factors are associated with the development of these problems. In order to better understand these relationships, a number of issues concerning design of research and measurement of DFA/DBMP have to be dealt with.

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Intramolecular hydrogen bonding in medicinal chemistry.

Bernd Kuhn, Peter Mohr, Martin Stahl (2010)

The formation of intramolecular hydrogen bonds has a very pronounced effect on molecular structure and properties. We study both aspects in detail with the aim of enabling a more rational use of this class of interactions in medicinal chemistry. On the basis of exhaustive searches in crystal structure databases, we derive propensities for intramolecular hydrogen bond formation of five- to eight-membered ring systems of relevance in drug discovery. A number of motifs, several of which are clearly underutilized in drug discovery, are analyzed in more detail by comparing small molecule and protein-ligand X-ray structures. To investigate effects on physicochemical properties, sets of closely related structures with and without the ability to form intramolecular hydrogen bonds were designed, synthesized, and characterized with respect to membrane permeability, water solubility, and lipophilicity. We find that changes in these properties depend on a subtle balance between the strength of the hydrogen bond interaction, geometry of the newly formed ring system, and the relative energies of the open and closed conformations in polar and unpolar environments. A number of general guidelines for medicinal chemists emerge from this study.

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Articaine hydrochloride: a study of the safety of a new amide local anesthetic.

Sheila S. Gagnon, S F Malamed, D Leblanc (2001)

Articaine is an amide local anesthetic introduced clinically in Germany in 1976 and subsequently throughout Europe, Canada and, in 2000, the United States. The authors report on three identical single-dose, randomized, double-blind, parallel-group, active-controlled multicenter studies that were conducted to compare the safety and efficacy of articaine (4 percent with epinephrine 1:100,000) with that of lidocaine (2 percent with epinephrine 1:100,000). A total of 1,325 subjects participated in these studies, 882 of whom received articaine 4 percent with epinephrine 1:100,000 and 443 of whom received lidocaine 2 percent with epinephrine 1:100,000. The overall incidence of adverse events in the combined studies was 22 percent for the articaine group and 20 percent for the lidocaine group. The most frequently reported adverse events in the articaine group, excluding postprocedural dental pain, were headache (4 percent), facial edema, infection, gingivitis and paresthesia (1 percent each). The incidence of these events was similar to that reported for subjects who received lidocaine. The adverse events most frequently reported as related to articaine use were paresthesia (0.9 percent), hypesthesia (0.7 percent), headache (0.55 percent), infection (0.45 percent), and rash and pain (0.3 percent each). Articaine is a well-tolerated, safe and effective local anesthetic for use in clinical dentistry.

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Author and article information

Contributors

Jian Pan

Journal

Journal ID (nlm-ta): J Dent Sci

Journal ID (iso-abbrev): J Dent Sci

Title: Journal of Dental Sciences

Publisher: Association for Dental Sciences of the Republic of China

ISSN (Print): 1991-7902

ISSN (Electronic): 2213-8862

Publication date PMC-release: 17 December 2020

Publication date (Print): October 2021

Publication date (Electronic): 17 December 2020

Volume: 16

Issue: 4

Pages: 1055-1065

Affiliations

[a ]State Key Laboratory of Oral Disease, West China Hospital of Stomatology, Sichuan University, Chengdu, China

[b ]National Clinical Research Center for Oral Diseases & Department of Oral and Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu, China

[c ]National Engineering Laboratory for Oral Regenerative Medicine, West China Hospital of Stomatology, Sichuan University, Chengdu, China

Author notes

[∗ ]Corresponding author. State Key Laboratory of Oral Diseases, West China Hospital of Stomatology, Sichuan University, #14 Third Section, Renmin Road South, Chengdu, 610041, China. jianpancn@ 123456scu.edu.cn

Article

Publisher Item ID: S1991-7902(20)30255-5

DOI: 10.1016/j.jds.2020.12.003

PMC ID: 8403808

PubMed ID: 34484571

SO-VID: f6f3b3ac-dae4-4d26-9fb7-05f5a7ac843e

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This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).

Local anesthesia in oral and maxillofacial surgery: A review of current opinion

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Abstract

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SICOT-J (Orthopedic surgery and traumatology)

Most cited references 141

Dental fear/anxiety and dental behaviour management problems in children and adolescents: a review of prevalence and concomitant psychological factors.

Intramolecular hydrogen bonding in medicinal chemistry.

Articaine hydrochloride: a study of the safety of a new amide local anesthetic.

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