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Effect of Injection Pressure of Infiltration Anesthesia to the Jawbone
Kenji Yoshida DDS, PhD,
 Eri Tanaka DDS, PhD,
 Hiroyoshi Kawaai DDS, PhD, and
 Shinya Yamazaki DDS, PhD
Article Category: Research Article
Volume/Issue: Volume 63: Issue 3
Online Publication Date: Jan 01, 2016
DOI: 10.2344/15-00024.1
Page Range: 131 – 138
To obtain effective infiltration anesthesia effect in the jawbone, high concentrations of local anesthetic are needed. However, to reduce pain experienced by patients during local anesthetic administration, low-pressure injection is recommended for subperiosteal infiltration anesthesia. Currently, there are no studies regarding the effect of injection pressure on infiltration anesthesia, and a standard injection pressure has not been clearly determined. Hence, this study considered the effect of injection pressure of subperiosteal
Figure 6. ; Change of lidocaine concentration in jawbone after infiltration anesthesia. At all time points, lidocaine concentration in jawbone in epinephrine addition group (E+) was significantly higher than that in epinephrine additive–free group (E0). ** P < .01 E+ versus E0. * P < .05 E+ versus E0.
Eri Tanaka,
 Kenji Yoshida,
 Hiroyoshi Kawaai, and
 Shinya Yamazaki
Figure 6. 
Figure 6. 

Change of lidocaine concentration in jawbone after infiltration anesthesia. At all time points, lidocaine concentration in jawbone in epinephrine addition group (E+) was significantly higher than that in epinephrine additive–free group (E0). ** P < .01 E+ versus E0. * P < .05 E+ versus E0.


Eri Tanaka,
 Kenji Yoshida,
 Hiroyoshi Kawaai, and
 Shinya Yamazaki
Figure 8. 
Figure 8. 

Change of lidocaine concentration in jawbone and oral mucosa in epinephrine addition group after infiltration anesthesia. Lidocaine concentration in jawbone was lower than that in oral mucosa at all time points, and no significant difference was observed between the concentration values of both groups.


Eri Tanaka,
 Kenji Yoshida,
 Hiroyoshi Kawaai, and
 Shinya Yamazaki
Figure 9. 
Figure 9. 

Change of lidocaine concentration in jawbone and oral mucosa in epinephrine additive–free group after infiltration anesthesia. Lidocaine concentration in jawbone was lower than that in oral mucosa only at the 10-minute time point. Values thereafter were reversed, and no significant difference was observed between the 2 concentration values of both groups.


Kenji Yoshida,
 Eri Tanaka,
 Hiroyoshi Kawaai, and
 Shinya Yamazaki
<bold>Figure 5</bold>
Figure 5

Change of jawbone lidocaine concentration after infiltration anesthesia. All 4 groups are compared with each other (6 comparisons). However, only comparisons with significant differences are displayed. The highest value was obtained at 10 minutes after infiltration anesthesia for all groups, and concentration decreased thereafter. Groups with a higher injection pressure had a significantly higher lidocaine concentration in the jawbone at all time intervals.


Eri Tanaka,
 Kenji Yoshida,
 Hiroyoshi Kawaai, and
 Shinya Yamazaki
Figure 2. 
Figure 2. 

Location of infiltration anesthesia: 0.5 mL of 2% of lidocaine containing 1 : 80,000 epinephrine or 0.5 mL of 2% of epinephrine additive-free lidocaine was infused into the right maxillae for 20 seconds. Injection site was the buccal side of the third molar on both sides (white arrow). Subperiosteal infiltration anesthesia was performed by touching the needle tip to the jawbone surface under the periosteum.


Kenji Yoshida,
 Eri Tanaka,
 Hiroyoshi Kawaai, and
 Shinya Yamazaki
<bold>Figure 2</bold>
Figure 2

Method of subperiosteal infiltration anesthesia. The needle tip was inserted into the gingivobuccal fold of the molar mesial buccal region of the right mandible. The local anesthetic was injected by attaching the needle tip to the alveolar bone. After a specified time interval, the periosteum was elevated, and approximately 0.12 g of jawbone was removed using bone-cutting forceps. Sample size (height × weight × depth) was 5 mm × 5 mm × 5 mm. The sample was collected within 1 minute to avoid the influence of the bleeding.


Eri Tanaka DDS, PhD,
 Kenji Yoshida DDS, PhD,
 Hiroyoshi Kawaai DDS, PhD, and
 Shinya Yamazaki DDS, PhD
Article Category: Research Article
Volume/Issue: Volume 63: Issue 1
Online Publication Date: Jan 01, 2016
Page Range: 17 – 24
During dental and oral surgery, a significant local anesthetic effect is needed, as not only do the soft tissues require surgery, but also the hard tissue such as jawbones because of surgical interventions. In current clinical dentistry practice, vasoconstrictive agents such as epinephrine are commonly added to local anesthetics to inhibit bleeding from the surgical site and to enhance local anesthetic efficacy by delaying absorption of the local anesthetic into the blood and thus prolonging activity. 1 – 5 Currently, the vasoconstrictor
Sachie Ogawa DDS,
 Masahiro Watanabe DDS,
 Hiroyoshi Kawaai DDS, PhD,
 Hitoshi Tada Ph, PhD, and
 Shinya Yamazaki DDS, PhD
Article Category: Other
Volume/Issue: Volume 61: Issue 2
Online Publication Date: Jan 01, 2014
Page Range: 53 – 62
In clinical research, it has been reported that the action of infiltration anesthesia on the jawbone was reduced significantly by elevation of the periosteal flap with irrigation by water or saline (EPFI) compared with nonelevation of the periosteal flap (NEPF). 1 In that report, significant differences were detected in the initial dose of local anesthetics (EPFI: 4.3 ± 1.4 mL; NEPF: 1.8 ± 0.9 mL) and in the duration of anesthesia action (EPFI: 38 ± 26 minutes; NEPF: 65 ± 27 minutes). These results suggested that the duration of
Sachie Ogawa,
 Masahiro Watanabe,
 Hiroyoshi Kawaai,
 Hitoshi Tada, and
 Shinya Yamazaki
<bold>Figure 1</bold>
. 
Figure 1 . 

Method of general anesthesia.


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