Root Damage Induced by Intraosseous Anesthesia. An in Vitro Investigation

Overview

Journal Med Oral Patol Oral Cir Bucal

Specialty Dentistry

Date 2012 Dec 12

PMID 23229260

Citations 3

Authors

Christian Graetz

Karim-Mohamed Fawzy-El-Sayed

Nicole Graetz

Christof-Edmund Dorfer

Affiliations

Soon will be listed here.

Abstract

Objectives: The principle of the intraosseous anesthesia (IOA) relies on the perforation of the cortical plate of the bone for direct application of the local anesthetic solution into the underlying cancellous structures. During this procedure, IOA needles might accidentally come in contact with the tooth roots. The aim of the current in vitro study was to examine the consequences of this 'worst case scenario' comparing five commercially available IOA systems.

Material And Method: Extracted human roots were randomly perforated using five different IOA systems with a drilling time ≤5s. To simulate normal in vivo conditions, the roots were kept humid during the drilling procedure. Data was statistically evaluated using F-test (SPSS16, SPSS Inc., Chicago, USA) and the significance level was set at p ≤ 0.05.

Results: All examined systems resulted in root perforation. Drill fractures occurred in either none 0% (Quicksleeper, Anesto, Intraflow, Stabident) or 100% (X-Tip) of the applications. Excessive heat generation, as evident by combustion odor as well as metal and tooth discoloration, appeared in 30% (Quicksleeper), 40% (Anesto), 60% (Intraflow), 90% (Stabident) and 100% (X-Tip) of all perforations.

Conclusion: Within the limits of in-vitro studies, the results show a potential for irreversible root damage that might be inflicted by an improper use of IOA systems.

Citing Articles

Focal mandibular osteonecrosis following intraosseous anesthesia: A case report.

Geusens J, Bauwens T, Fransen J, Van de Vyvere G Int J Surg Case Rep. 2025; 127:110910.

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Clinical evaluation of efficacy of transcortical anesthesia for the extraction of impacted mandibular third molars: a randomized controlled trial.

Demir E, Ataoglu H J Dent Anesth Pain Med. 2020; 20(1):9-17.

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Inferior alveolar nerve block by intraosseous injection with Quicksleeper® at the retromolar area in mandibular third molar surgery.

Sovatdy S, Vorakulpipat C, Kiattavorncharoen S, Saengsirinavin C, Wongsirichat N J Dent Anesth Pain Med. 2019; 18(6):339-347.

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Intraosseous vascular access through the anterior mandible--a cadaver model pilot study.

Goldschalt C, Doll S, Ihle B, Kirsch J, Mutzbauer T PLoS One. 2014; 9(11):e112686.

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