Acta Stomatologica Naissi (Jan 2023)
Modified mylohyoid anesthesia with 4% articaine and with adrenaline and dexasamethasone in mandibular molar surgery: A pilot study
Abstract
Introduction: Mylohyoid mandibular anesthesia is not a standard and independent primary anesthesia for performing surgery on mandibular teeth. Objective: The objective was to examine the success of achieved mylohyoid anesthesia for mandibular molar surgery, by injecting an anesthetic that could penetrate the bone in the lingual region of the mandible, using the technique for modified mylohyoid mandibular anesthesia. Materials and methods: In the pilot study, 10 patients were divided into 2 equal groups (of 5 patients each), of both sexes and aged 18-75, who required mandibular anesthesia owing to mandibular molar surgery. In group I, 3.5 ml of 4% articaine with 1:100000 adrenaline, and the addition of 0.5 ml/4 mg of dexamethasone, was injected into the sublingual region of the corner of the mandible using a modified mylohyoid approach; in group II, 4 ml of 2% lidocaine with 1:100000 adrenaline was injected into the region of the mandibular foramen using the approach for standard mandibular conduction direct anesthesia. A visual analogue scale (VAS) was used for the subjective assessment of the pain during surgery in patients, the recorded duration of the realized mandibular anesthesia, as well as the total effectiveness of the achieved anesthesia, expressed in percentages. Results: A successful intervention was achieved in all patients, with different VAS scores, but within the values indicating successful anesthesia (group I: 17.40±11.10mm; group II: 12.80±4.55mm). A longer duration of anesthesia was achieved in the first group-205.2 min (3h 25 min), compared to the second group-182 min (3h 2 min). Conclusion: Mylohyoid mandibular anesthesia with 4% articaine and with adrenaline and dexamethasone could be applied as primary anesthesia for the purpose of successfully achieving standard mandibular anesthesia.
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