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Comparison of Pain Perception Using Conventional Versus Computer-Controlled Intraligamentary Local Anesthetic Injection for Extraction of Primary Molars
Meenu Mittal BDS, MDS,
 Radhika Chopra BDS, MDS,
 Ashok Kumar BDS, MDS, and
 Dhirendra Srivastava BDS, MDS, MOMS, RCPS (Glasgow)
Article Category: Research Article
Volume/Issue: Volume 66: Issue 2
Online Publication Date: Jan 01, 2019
DOI: 10.2344/anpr-66-01-09
Page Range: 69 – 76

, to obtain sufficient anesthesia of the desired region, relatively large doses of anesthetic agent may be required. 1 In intraligamentary anesthesia (ILA), anesthetic solution is injected with pressure in the periodontal ligament (PDL) space and placed directly into the cancellous bone adjacent to the tooth to be anesthetized. 3 With ILA, specific teeth are anesthetized with less residual and soft tissue anesthesia, and thus discomfort and potential self-mutilation of nerve block anesthesia are avoided. 4 However, there are some potential problems with the

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Figure 1.; Numbee packaging and the Numbee attached to BioDent's “Intraligamental Syringe” (intraligamentary, pen-style syringe).
Coleman Christensen,
 Stephen C. Arnason,
 Ross Oates,
 Michael Crabtree,
 John W. Kersey Jr, and
 Kraig S. Vandewalle
Figure 1.
Figure 1.

Numbee packaging and the Numbee attached to BioDent's “Intraligamental Syringe” (intraligamentary, pen-style syringe).

Figure 3.; Intraligamentary injection with the Numbee in the mesial sulcus of tooth #28.
Coleman Christensen,
 Stephen C. Arnason,
 Ross Oates,
 Michael Crabtree,
 John W. Kersey Jr, and
 Kraig S. Vandewalle
Figure 3.
Figure 3.

Intraligamentary injection with the Numbee in the mesial sulcus of tooth #28.

Prospective Study on PDL Anesthesia as an Aide to Decrease Palatal Infiltration Pain
Brian Crump DMD, MS,
 Al Reader DDS, MS,
 John Nusstein DDS, MS,
 Melissa Drum DDS, MS,
 Sara Fowler DMD, MS, and
 John Draper PhD
Article Category: Research Article
Volume/Issue: Volume 69: Issue 1
Online Publication Date: Apr 04, 2022
DOI: 10.2344/anpr-68-03-03
Page Range: 10 – 17

.  Nusstein J, Berlin J, Reader A, Beck M, Weaver J. Comparison of injection pain, heart rate increase, and postinjection pain of articaine and lidocaine in a primary intraligamentary injection administered with a computer-controlled local anesthetic delivery system . Anesth Prog

Figure 2.; Comparison of Numbee and periodontal ligament (PDL) injection. (a) Gingival sulcus is the target for a Numbee injection. (b) Numbee. (c) Dental needle. (d) PDL is the target for a traditional intraligamentary injection using a needle.
Coleman Christensen,
 Stephen C. Arnason,
 Ross Oates,
 Michael Crabtree,
 John W. Kersey Jr, and
 Kraig S. Vandewalle
Figure 2.
Figure 2.

Comparison of Numbee and periodontal ligament (PDL) injection. (a) Gingival sulcus is the target for a Numbee injection. (b) Numbee. (c) Dental needle. (d) PDL is the target for a traditional intraligamentary injection using a needle.

Figure 1. ; The Heft Parker VAS. The numbers at the top of the scale were omitted on the patients' VAS. VAS indicates visual analog scale.
Brian Crump,
 Al Reader,
 John Nusstein,
 Melissa Drum,
 Sara Fowler, and
 John Draper
<bold>Figure 1.</bold>  
Figure 1.  

The Heft Parker VAS. The numbers at the top of the scale were omitted on the patients' VAS. VAS indicates visual analog scale.

Figure 2. ; PDL injection. Placement of the 27-gauge ultra-short needle in the gingival sulcus and initial blanching of the gingival collar at the start of the PDL injection. PDL indicates periodontal ligament.
Brian Crump,
 Al Reader,
 John Nusstein,
 Melissa Drum,
 Sara Fowler, and
 John Draper
<bold>Figure 2.</bold>  
Figure 2.  

PDL injection. Placement of the 27-gauge ultra-short needle in the gingival sulcus and initial blanching of the gingival collar at the start of the PDL injection. PDL indicates periodontal ligament.

Figure 3. ; Pain ratings by VAS category. The first 4 columns represent needle insertion and solution deposition for the PDL and mock PDL injections. The last 4 columns represent needle insertion and solution deposition for the PDL-aPI injections and the mPDL-cPI injections. VAS indicates visual analog scale; PDL, periodontal ligament; PDL-aPI, PDL injection and alternative palatal infiltration; mPDL-cPI, mock PDL injection and conventional palatal infiltration.
Brian Crump,
 Al Reader,
 John Nusstein,
 Melissa Drum,
 Sara Fowler, and
 John Draper
<bold>Figure 3.</bold>  
Figure 3.  

Pain ratings by VAS category. The first 4 columns represent needle insertion and solution deposition for the PDL and mock PDL injections. The last 4 columns represent needle insertion and solution deposition for the PDL-aPI injections and the mPDL-cPI injections. VAS indicates visual analog scale; PDL, periodontal ligament; PDL-aPI, PDL injection and alternative palatal infiltration; mPDL-cPI, mock PDL injection and conventional palatal infiltration.

Figure 4. ; Models of the Extent of Palatal Anesthesia. The top image is the PDL-aPI technique, and the bottom image is the mPDL-cPI technique. The small “dot” on each image is the location of the approximate palatal injection site. The mPDL-cPI technique produced a larger area of soft tissue anesthesia. PDL-aPI indicates PDL injection and alternative palatal infiltration; mPDL-cPI, mock PDL injection and conventional palatal infiltration.
Brian Crump,
 Al Reader,
 John Nusstein,
 Melissa Drum,
 Sara Fowler, and
 John Draper
<bold>Figure 4.</bold>  
Figure 4.  

Models of the Extent of Palatal Anesthesia. The top image is the PDL-aPI technique, and the bottom image is the mPDL-cPI technique. The small “dot” on each image is the location of the approximate palatal injection site. The mPDL-cPI technique produced a larger area of soft tissue anesthesia. PDL-aPI indicates PDL injection and alternative palatal infiltration; mPDL-cPI, mock PDL injection and conventional palatal infiltration.

Anesthetic Efficacy of Meperidine in Teeth With Symptomatic Irreversible Pulpitis
Ladan Mohajeri DDS, MS,
 Farnaz Salehi DDS,
 Payman Mehrvarzfar DDS, MS,
 Hamide Arfaee DDS,
 Behnam Bohluli DDS, MS, and
 Reza Hamedy DDS
Article Category: Other
Volume/Issue: Volume 62: Issue 1
Online Publication Date: Jan 01, 2015
DOI: 10.2344/0003-3006-62.1.14
Page Range: 14 – 19

to lidocaine in IANB for pain management in normal teeth 24 and also in teeth with irreversible pulpitis 25 has been studied. The aim of our study was to compare the efficacy of local anesthetics with and without meperidine for intraligamentary supplemental injection for teeth with irreversible pulpitis. Our null hypothesis stated that the addition of meperidine to standard lidocaine with epinephrine does not improve the efficacy of supplemental intraligamentary anesthesia in teeth with symptomatic irreversible pulpitis. The specific objectives were to randomly