The Bevel Effect: a Prospective, Randomized Investigation into Needle Design in Dental Intraligamentary Anesthesia

Overview

Journal Clin Oral Investig

Specialty Dentistry

Date 2024 Feb 23

PMID 38396049

Authors

P W Kammerer

H Staedt

K Wesslau

I Buttchereit

H L Stiller

T Frankenberger

M Dau

Affiliations

Soon will be listed here.

Abstract

Objectives: This in vivo study aimed to assess the impact of needle bevel design on puncture pain, anesthetic success, and mechanical deformations in intraligamentary injection (ILA) cases, comparing a short triple facet cut (STF) to a triple lancet cut (TL) after single or repetitive use.

Materials And Methods: In a prospective single-blind trial, 200 ILA needles (STF, n = 100; TL, n = 100) were randomly assigned for dental procedures. Patients received ILA either with STF or TL needles, used once (group A; n = 50 each) or repeatedly (group B; n = 50). Puncture pain was assessed using a numerical rating scale (NRS). Anesthetic success was determined via cold spray (yes/no), and scanning electron microscopy (SEM) analyzed needle tip deformations.

Results: Puncture pain did not significantly differ between STF and TL, regardless of needle use or injection area. Success rates were comparable in single use (82% STF vs. 79% TL; p > 0.05). For repetitive use, STF exhibited a significantly higher success rate (80% vs. 69%; p = 0.012). Mechanical deformations were prevalent in 97.5% of needles, with TL showing greater deformations than STF after single and repeated uses. Barbs were more common in TL (90/100) than STF (84/100), with a higher relative risk for barbed-like deformation in TL (RR single use: 1.26; p < 0.001; multiple use: 7.87, p < 0.001).

Conclusions: The short triple facet-designed bevel demonstrated significantly less mechanical deformation, suggesting potential advantages in maintaining needle lumen patency.

Clinical Relevance: The intraligamentary needle bevel design is linked to mechanical deformation and anesthetic success after repetitive use, but not to puncture pain.

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