مقايسه ميزان عدم موفقيت بي حسي موضعي در دندانهاي آسياي اول فك بالا و پايين

Comparison of the Rate of Local Anesthesia Failure in Maxillary and Mandibular First Molars

Background and Objectives:Achieving complete anesthesia is a major problem in dental procedures, especially in endodontic treatment. Several studies on local anesthesia have indicated the highest rate of failures in mandibular teeth. The aim of this study was to compare the rate of local anesthesia failure in mandibular and maxillary first molars and find out the rate of failure and recognize the potential factors involved in order to achieve a profound local anesthesia rendering endodontic treatment as painless as possible. Materials and Methods:50 first molar teeth from 50 patients (25 mandibular first molars and 25 maxillary first molars) with vital pulps and normal PDL , Iamina dura on radiographic examination and without any sensitivity to percussion and palpation needing endodontic treatment were evaluated. Results: Of 25 maxillary first molars only 2 teeth needed supplemental injections, whereas 8 teeth out of 25 mandibular first molars needed supplemental injections. Results of the statistical analysis (Chi-square) showed a statistically significant higher rate of local anesthesia failure in mandibular first molars compared with maxillary first molars (P=0.034). Conclusion: The current study indicated that local anesthesia failure rate was significantly higher in mandibular first molars compared to maxillary first molars and that achieving a proper local anesthesia in the teeth having preoperative pain was more difficult. Therefore, in order to achieve a proper anesthesia and render painless endodontic treatment supplemental, injections should be carried out especially for mandibular first molars.