Should Maxillary Buccal Infiltration Anesthesia be Given in a Closed Mouth Technique?

Study Overview
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Brief Summary
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To study the patients' and dentists' perception of receiving/ administering maxillary buccal infiltration anesthesia using an open or closed mouth techniques

Detailed Description
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Background: Local anesthesia is an essential part of dentistry. The most commonly used technique to anesthetise maxillary posterior teeth is buccal infiltration with a local anesthetic agent. The technique described in the literature focuses on the location of injection, the direction of the needle insertion in relation to the root apex, the direction of needle bevel in relation to the cortical bone plate, the size of needle and the type and amount of the local anesthetic agent used. However, there is no mention to whether the patient should open their mouth or maintain their teeth in intercuspation during the injection procedure. Aims: This research aims to a) compare two techniques of injection (open and closed-mouth techniques) in terms of the discomfort experienced by patients during the injection procedure and b) evaluate the dentists' preference in performing either of the two techniques.

Official Title
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Should Maxillary Buccal Infiltration Anesthesia be Given in a Closed Mouth Technique? - a Clinical Study

Conditions
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Anesthesia, Local, Pain Control

Intervention / Treatment
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* Procedure: Local anesthesia


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Adult patients (16 years old and older) Healthy (American Society of Anaesthesiologists (ASA) category I or II) A maxillary posterior tooth (excluding third molars) referred for root canal treatment and diagnosed with irreversible pulpitis and normal apical tissues Exclusion Criteria: Psychological disorders Intraoral soft tissue abnormalities necrotic pulp with/ without apical pathology tenderness to palpation and/or percussion The use of analgesics in the preceding 12 hours before the appointment.

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Other
Allocation: Randomized
Intervention Model: Parallel Assignment
Interventional Model Description: Providing dental local anesthesia (maxillary buccal infiltration) using two techniques; open-mouth and closed-mouth
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Active Comparator: Open-mouth<br>Patients receiving maxillary buccal infiltration anesthesia (MBIA) with their mouth wide open | Procedure: Local anesthesia<br>* Patients scheduled for a dental procedure that requires local anesthesia will be given the injection using two 2 techniques; an open-mouth and closed-mouth techniques<br>|
| Experimental: Closed-mouth<br>Patients receiving MBIA using a closed-mouth technique | Procedure: Local anesthesia<br>* Patients scheduled for a dental procedure that requires local anesthesia will be given the injection using two 2 techniques; an open-mouth and closed-mouth techniques<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Patient Pain Perception | Pain perception during local anesthesia injection on a standard 100mm visual analogue scale (VAS) where zero indicates no pain at all and 100 indicates intolerable pain/ worst imagined pain (scale attached in the protocol section). The average scores were calculated for each group and compared. Higher values indicated higher pain/ discomfort experienced during the injection procedure. | 5 minutes after receiving the injection | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Dentist Perception of Visibility During Anesthesia Injection | Participating dentists were asked to rate the visibility of injection site and ease of cheek retraction during injection on a standard 100mm visual analogue scale where 100 indicates the best possible visibility/ easiest cheek retraction and 0 means no visibility at all/ most difficult cheek retraction. The mean scores were compared between the 2 groups using independent t-test. | 30-60 days | 
| Dentist Preference of Performing One of the Two Techniques of Maxillary Buccal Infiltration; Open-mouth or Closed-mouth | Number of dentists preferring each technique | 3-60 days | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Buccal infiltration anesthesia, Discomfort