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Anaesthesia of the Long Buccal Nerve Research Article Adv Dent & Oral Health Volume Issue 2 - June 2017 Copyright © All rights are reserved by : Lemya Babiker Sanhori DOI: 10.19080/ADOH.2017.07.555657 Anaesthesia of the Long Buccal Nerve Lemya Babiker Sanhori* and Elneel Ahmed Mohmed University of Medical Sciences and Technology, Sudan Submission: February 18, 2017; Published: June 29, 2017 *Corresponding author: Lemya Babiker Sanhori, University of Medical Sciences and Technology, Sudan, Tel: ; Email: Abstract Background: Painless dental procedure was the main goal behind inventing different methods of local anaesthesia. The block techniques of also important. local anaesthesia have shown some difficulties in application and prolong time to produce an effect. Hence the role of infiltration anaesthesia is Objective: teeth. The aim of this study was to identify the best area to anaesthetize the long buccal nerve in intra-alveolar extraction of posterior Study design: Controlled experimental hospital based study. Patients and methods: Two hundred fifty seven patients was selected randomly all the patients were between 20- 40 years, presented for extraction of the lower posterior teeth at KTDH during the period 2008-2011.Patients were categorized into three groups, the first had given block anaesethesia for the long buccal nerve, the second had given infiltration anaesthesia in between the roots of the tooth to be extracted and the thirdResults: had given infiltration anaesthesia mesial to the tooth to be extracted.Then anaesthesia was tested and the time was measured. The onset of anaesthesia was faster in the second group as 64.70% of the patients were anaestized in 0-30 seconds in comparison to 19.10%Conclusion: and 16.20% In extraction in the first of lower and thirdposterior groups teeth respectively. the injection of local anaesthesia in between the roots gives more rapid onset of anaesthesia for the long buccal nerve. Keywords: Anaesthesia; Long buccal nerve; Block anaesthesia; Infiltration Anaesthesia Introduction The use of local anaesthesia in most of the branches of A. Anatomical factors. Like extra innervation from the dentistry makes it necessary to bring more effort to develop the mylohyoid nerve, abnormal anatomy of the area, or sensory means by which it becomes more potent and easier to apply. Dental practice and especially the minor surgical ones fibers from the cutaneous coli [2-10]. usually done to alleviate pain but also it is vital to have a painless C. Small amount of anesthetic solution as in some block procedure for that.The use of local anaesthesia is preferable over B. Inadequate concentration of anesthetic agent [4]. techniques, it is not safe to give large amount to avoid pressure complications [2]. the use of general anaesthesia [1]. general anaesthesiaas there are many difficulties associated with Block anaesthesia of the long buccal nerve still shows some environment increases the action potential that is transmitted failure with various techniques at the buccal mucosa, gingival, and D. In case of inflammation, the presence of acidic cortical bone of the mandibular posterior teeth when compared along the sensory nerve [1,3,4]. place in some blocking techniques [2]. withLooking infiltration for factorsanesthesia responsible [2-4]. for failure and slow onset of E. Difficulty in delivering anesthetic solution in the right anesthesia of the long buccal nerve in the mandibular posterior This research is mainly to determine the best site of anesthesia technique; It might be found that some logical explanations are molars in patients attending Khartoum Teaching Dental Hospital teeth that makes the infiltration technique superior to the block of the long buccal nerve by infiltration type for the mandibular there: (KTDH). Adv Dent & Oral Health 5(2) : ADOH.MS.ID.555657 (2017) 001 Advances in Dentistry & Oral Health Methods The study was conducted at Khartoum Teaching Dental Hospital for patients coming for extraction of the lower posterior experimental hospital based study. teeth during (2008-2011). The study design was controlled The study size was257 patient. Inclusion Criteria as following: alveolar extraction of mandibular second and third molar. age between 20-40. Male and female patients coming for intra- alveolar extraction were excluded. Data collection sheet, Figure 3: Comparison between the sites of anaesthesia against Extraction of first molar, presence of infection and Trans- questionnaire, mirror, probe, syringe, tweezer, disposable needles time. (mid: Middle; Ms: Mesial; Ds: Distal). used to collect the data. 27 gauge and 1.8ml cartridge of 2% lidocaine and stop watch were Study Method After selection of patients, patients will be seated in the dental chair and categorized randomly into three groups. History and patient. The three groups will be injected with 0.6 ml of lidocaine examination will be done. Then the consent will be filled by the injected distal and buccal to the last molar in the oral cavity with to anaesthetize the long buccal nerve. The first group will be the needle parallel to the lower occlusal plane.The second one will be injected in between the roots of the tooth to be extracted with Figure 4: The relation between the on set of anaesthesia in teeth with operculum against teeth without operculum. the needle 45degree at the sulcus. The third one will be injected the sulcus. Each patients will be tested objectively and subjectively mesial to the tooth to be extracted with the needle 45degree at and more than 120secs respectively. Data sheet will be completed. for the onset of anaesthesia at times 0-30, 31-60, 61-90,91-120 Then the results will be analysed and compared. Stata version 8 was used for data analysis. Verbal and written consent taken from the patient. Written consent taken from KTDH. Results Figure 5: The relation between the on set of anaesthesia in teeth with operculum against teeth without operculum. Figure 1: Patients distribution according to gender. Figure 6: The relation between the on set of anaesthesia in teeth with operculum against teeth without operculum. Figure 2: Comparison between male and female patients in each time field. Figure 1-6, Table 1-5. How to cite this article: Lemya B S, Elneel A M. Anaesthesia of the Long Buccal Nerve. Adv Dent & Oral Health. 2017; 5(2): 555657. DOI: 10.19080/ 002 ADOH.2017.05.555657. Advances in Dentistry & Oral Health Table 1: Descriptive analysis of the study. Time 0 to 30secs 31 to 60 secs 61 to 90 sec 91 to 120 sec More than 120 secs Total Frequency Percent Frequency Percent Frequency Percent Frequency Percent Frequency Percent Frequency Percent Gender Female 16 10 78 170 Male 4226 61.80% 9 64.00% 24 63.20% 6 62.50% 32 70.90% 87 66.10% Total 68 38.20% 25 36.00% 1438 36.80% 16 37.50% 110 29.10% 257 33.90% 100.00% 100.00% 100.00%Site 100.00% 100.00% 100.00% Mid 13 11 86 Ms 4411 64.70% 7 52.00% 148 36.80% 45 25.00% 55 10.00% 86 33.50% Ds 13 16.20% 5 28.00% 16 21.10% 7 31.30% 50.00% 85 33.50% Total 68 19.10% 25 20.00% 38 42.10% 16 43.80% 11044 40.00% 257 33.10% 100.00% 100.00% 100.00%Operculun 100.00% 100.00% 100.00% No 59 21 27 11 67 185 Yes 9 86.80% 84.00% 11 71.10% 5 68.80% 60.90% 72 72.00% Total 68 13.20% 254 16.00% 38 28.90% 16 31.30% 11043 39.10% 257 100.00528.00% 100.00% 100.00% 100.00%Eight 100.00% 100.00% No 11 2 2 16 35 Yes 5 68.80% 43 57.10% 3 40.00% 2 50.00% 7 69.60% 20 63.60% Total 16 31.30% 7 42.90% 5 60.00% 50.00% 23 30.40% 55 36.40% Tooth 100.00% 100.00% 100.00% 4 100.00% 100.00% 100.00% Right 8 17 12 18 105 Left 8 35 25.00% 6 48.00% 15 47.40% 48 25.00% 5433 49.40% 97 40.90% Right 7 6 51.50% 5 24.00% 3 39.50% 2 50.00% 13 30..00% 29 37.70% Left 7 10 8.80% 2 20.00% 2 7.90% 2 12.50% 10 11.80% 26 11.30% Total 68 14.71% 25 8.00% 38 5.30% 16 12.50% 110 9.10% 257 10.10% Table 2: Percentage100.00% of gender distribution.100.00% 100.00%Table 4: Significance100.00% of the site in relation100.00% to the distal injection. 100.00% Time Mid Ms. Gender Frequency Percent rrr P-Value rrr P-Value 0 to 30 secs 0.00 0.68 0.39 Female 170 31 to 60 13.54 0.00 1.12 0.86 secs 66.10% 61 to 90 10.4 3.5 0.01 0.06 Male 87 secs 33.90% 91 to120 0.4 2.29 0.25 0.57 0.37 secs Total 257 Table 5: Significance of the variables. 100.00% Table 3: Analysis of the age of patients. Variable Time Sig Test name Obs Mean Std.Dev. Min Max Operculum 0.003 chi Site 0 chi Eight 0.695 Age 257 28.40 5.55 20 40 Gender 0.737 fisherchi How to cite this article: Lemya B S, Elneel A M. Anaesthesia of the Long Buccal Nerve. Adv Dent & Oral Health. 2017; 5(2): 555657. DOI: 10.19080/ 003 ADOH.2017.05.555657. Advances in Dentistry & Oral Health Discussion The presence of operculum shows delay in the onset of anaesthesia. The highest percentage of the teeth with operculum In Sudan no previous studies were conducted in Oral and was anaesthetized at more than 120 seconds by a percentage of Maxillofacial Surgery in relation to the anaesthesia of the long buccal nerve.
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