Editorial Type:
Article Category: Other
 | 
Online Publication Date: Jan 01, 2013

Effect of Massage on the Efficacy of the Mental and Incisive Nerve Block

PhD, BDS,
PhD, BChD,
PhD, BDS,
MSc, BDS,
MSc, BDS, and
PhD, BDS
Page Range: 15 – 20
DOI: 10.2344/12-00024.1
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Abstract

The purpose of this trial was to assess the effect of soft tissue massage on the efficacy of the mental and incisive nerve block (MINB). Thirty-eight volunteers received MINB of 2.2 mL of 2% lidocaine with 1 : 80,000 epinephrine on 2 occasions. At one visit the soft tissue overlying the injection site was massaged for 60 seconds (active treatment). At the other visit the crowns of the mandibular premolar teeth were massaged (control treatment). Order of treatments was randomized. An electronic pulp tester was used to measure pulpal anesthesia in the ipsilateral mandibular first molar, a premolar, and lateral incisor teeth up to 45 minutes following the injection. The efficacy of pulp anesthesia was determined by 2 methods: (a) by quantifying the number of episodes with no response to maximal electronic pulp stimulation after each treatment, and (b) by quantifying the number of volunteers with no response to maximal pulp stimulation (80 reading) on 2 or more consecutive tests, termed anesthetic success. Data were analyzed by McNemar, Mann-Whitney, and paired-samples t tests. Anesthetic success was 52.6% for active and 42.1% for control treatment for lateral incisors, 89.5 and 86.8% respectively for premolars, and 50.0 and 42.1% respectively for first molars (P = .344, 1.0, and .508 respectively). There were no significant differences in the number of episodes of negative response to maximum pulp tester stimulation between active and control massage. A total of 131 episodes were recorded after both active and control massage in lateral incisors (McNemar test, P = 1.0), 329 (active) versus 316 (control) episodes in the premolars (McNemar test, P = .344), and 119 (active) versus 109 (control) episodes respectively for first molars (McNemar test, P = .444). Speed of anesthetic onset and discomfort did not differ between treatments. We concluded that soft tissue massage after MINB does not influence anesthetic efficacy.

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Copyright: © 2013 by the American Dental Society of Anesthesiology
Figure 1. 
Figure 1. 

Percentage of volunteers with no response to electronic pulp testing at time intervals after mental and incisive nerve block and active or control massage in lateral incisors.


Figure 2. 
Figure 2. 

Percentage of volunteers with no response to electronic pulp testing at time intervals after mental and incisive nerve block and active or control massage in premolars.


Figure 3. 
Figure 3. 

Percentage of volunteers with no response to electronic pulp testing at time intervals after mental and incisive nerve block and active or control massage in first molars.


Contributor Notes

Address correspondence to J. G. Meechan, Centre for Oral Health Research, School of Dental Sciences, Newcastle University, Framlington Place, Newcastle upon Tyne, NE2 4BW, United Kingdom; john.meechan@ncl.ac.uk.
Received: Jun 12, 2012
Accepted: Dec 05, 2012