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Volume of Anesthetic Agents and IANB Success: A Systematic Review.

Abstract

The aim of this study was to provide an evidence-based answer to the question: "Is 3.6-mL volume of an anesthetic agent more effective than 1.8-mL volume in providing anesthesia for mandibular molars?" Following formulation of research question and keyword selection, a comprehensive search of the following databases was conducted: Cochrane library, PubMed, Scopus, Google Scholar, ProQuest, and Clinicaltrials.gov. Three-phase eligibility appraisal and quality assessment of the studies were carried out by 2 independent reviewers. To reduce clinical heterogeneity, the included studies were divided into 2 groups: studies on healthy teeth and studies on teeth with pulpitis. The data of included studies were statistically combined through meta-analysis using a fixed-effects model. A total of 20,778 records were initially retrieved from the search. Following screening and eligibility assessment, 8 studies met the eligibility criteria and were included for qualitative synthesis. Of those, 5 studies were qualified for meta-analysis. In the irreversible pulpitis group, increasing the volume of anesthetic agent from 1.8 to 3.6 mL significantly increased the success rate of inferior alveolar nerve block (risk ratio = 2.45, 95% CI: 1.67-3.59, p < .001). However, there was insufficient evidence to draw a conclusion regarding healthy teeth.

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  • Authors+Show Affiliations

    ,

    Assistant Professor, Dental and Periodontal Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.

    ,

    Associate Professor, Department of Endodontics, Faculty of Dentistry, Tabriz University of Medical Sciences, Tabriz, Iran.

    ,

    Professor of Endodontics, Dental and Periodontal Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.

    ,

    Associate Professor, Department of Endodontics, Faculty of Dentistry, Tabriz University of Medical Sciences, Tabriz, Iran.

    Associate Professor of Biostatistics, Department of Statistics and Epidemiology, Faculty of Health, Tabriz University of Medical Sciences, Tabriz, Iran.

    Source

    Anesthesia progress 65:1 pg 16-23

    Pub Type(s)

    Journal Article

    Language

    eng

    PubMed ID

    29509518

    Citation

    TY - JOUR T1 - Volume of Anesthetic Agents and IANB Success: A Systematic Review. AU - Milani,Amin Salem, AU - Froughreyhani,Mohammad, AU - Rahimi,Saeed, AU - Zand,Vahid, AU - Jafarabadi,Mohammad Asghari, PY - 2018/09/01/pmc-release PY - 2018/3/7/entrez PY - 2018/3/7/pubmed PY - 2018/3/7/medline KW - Anesthetic success KW - Anesthetic volume KW - Inferior alveolar nerve block KW - Mandibular molar KW - Meta-analysis KW - Systematic review SP - 16 EP - 23 JF - Anesthesia progress JO - Anesth Prog VL - 65 IS - 1 N2 - The aim of this study was to provide an evidence-based answer to the question: "Is 3.6-mL volume of an anesthetic agent more effective than 1.8-mL volume in providing anesthesia for mandibular molars?" Following formulation of research question and keyword selection, a comprehensive search of the following databases was conducted: Cochrane library, PubMed, Scopus, Google Scholar, ProQuest, and Clinicaltrials.gov. Three-phase eligibility appraisal and quality assessment of the studies were carried out by 2 independent reviewers. To reduce clinical heterogeneity, the included studies were divided into 2 groups: studies on healthy teeth and studies on teeth with pulpitis. The data of included studies were statistically combined through meta-analysis using a fixed-effects model. A total of 20,778 records were initially retrieved from the search. Following screening and eligibility assessment, 8 studies met the eligibility criteria and were included for qualitative synthesis. Of those, 5 studies were qualified for meta-analysis. In the irreversible pulpitis group, increasing the volume of anesthetic agent from 1.8 to 3.6 mL significantly increased the success rate of inferior alveolar nerve block (risk ratio = 2.45, 95% CI: 1.67-3.59, p < .001). However, there was insufficient evidence to draw a conclusion regarding healthy teeth. SN - 1878-7177 UR - https://www.unboundmedicine.com/medline/citation/29509518/Volume_of_Anesthetic_Agents_and_IANB_Success:_A_Systematic_Review. L2 - http://www.anesthesiaprogress.org/doi/10.2344/anpr-65-01-03?url_ver=Z39.88-2003&amp;rfr_id=ori:rid:crossref.org&amp;rfr_dat=cr_pub=pubmed ER -