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Official Publication of Orofacial Chronicle , India

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ORIGINAL RESEARCH
Needle tip deformation after PDL and Intraseptal dental
local anesthesia
A.V.Kuzin, PhD
1
Yu.V.Ereskina
2
A.A. Kurtyshov
2

1-I.M. Sechenov First Moscow State Medical University, department of oral
surgery. 2- I.M. Sechenov First Moscow State Medical University, student of
Dentistry Faculty.
ABSTRACT:
The comparative analysis of dental needle tip deformation after periodontal
anesthesia for the increasing it safety was carried out.
Methods: 47 needles with "a standard bevel" and "surgical bevel" were selected
after PDL and intraseptal anesthesia in 24 patients. In a view under microscope
deformation of needles tips were observed.
Results: In all cases of periodontal anesthesia the deformation of the tips looked
like a bends under various angle. Bends from 15 to 180 to needle axis are noted.
These deformations arise at single use of a needle. After anesthesia of multiroot
teeth where from two to four injections were carried out, needle tip deformations
were also revealed.
Conclusion: Therefore for one periodontal injection - one needle is necessary, and
in cases of multi-root teeth 2 - 4 needles are needed. The smallest deformation was
observed in needles "surgical edge" type that is associated with a smaller length of
a bevel and its two-edged sharpening.

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Keywords: local anesthesia, PDL anesthesia, intraseptal anesthesia, needle tip
deformation, needle bevel.
Cite this Article: A.V.Kuzin, Yu.V. Ereskina A, A. Kurtyshov: Needle tip deformation after PDL
and Intraseptal dental local anesthesia, Journal of Head & Neck physicians and surgeons Vol 2
Issue 1 2014 : Pg 48-52

INTRODUCTION:

Intraseptal and PDL anesthesia techniques require from 1 to 4 injections to get
anesthesia for 1 tooth. Until now the question of needle tip deformation after
periodontal local anesthesia is unknown. Needle tip deformation with bevel like
surgical edge was not investigated.The comparative analysis of dental needle tip
deformation after periodontal anesthesia to increase its safety.
OBJECTIVES:
1. Study of needle tip deformation with regular bevel and surgical edge
after periodontal anesthesia.
2. Needle tip deformation after single-rooted tooth and multirooted tooth
anesthesia.
MATERIAL AND METHODS:
There was performed treatment of 24 patients having indications for tooth
extraction with periodontal local anesthesia: PDL and Intraseptal anesthesia.
After local anesthesia 47 needles with different bevel type were selected to
study the degree of their tip deformation under the microscope. Needles were
arranged in groups depending on kind of anesthesia, company manufactured
needles and single or multiple using. There were used the following needles type:
with regular bevel (fig.1) Uniject 27G, Nipro 30G and with bevel like
surgical edge Septoject Evolution 27G (fig.2). Neddle tip deformation was
examined by means of optical microscope LOMO under 4/0*10 magnification
with object-plate illumination under different angle. Every needle photographed in
front and lateral projections (Sony Alpha DSLR-A230). Every needle was fixed on
the clean plate by an epoxy adhesive. After the research needles were plunged

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down to the sharps container to collect sharp tools, utilization was in compliance
with sanitary rules.

Fig.1: Needle tip with regular bevel. Control group. Photo. Microscope magnification X 40.


Fig.2: Needle tip with bevel like surgical edge. Control group. Photo. Microscope magnification
40.

RESULTS:
In our research there were revealed the following needle tip deformation
types: upright bend (turned to the bevel), reverse bend. In some cases the tip
deformation was so evident and a tip was so reversed from the place of injection
(form-of-U bend). After PDL anesthesia the needles with regular bevel
(Uniject) have shown upright bend in 11,1%, reverse bend 0%, form-of-U
bend 77,8% (fig.3), absence of deformation was not noted. High percentage of
form-of-U bend relates to technique of PDL anesthesia. Long tip of this bevel
undergo a strong mechanical resistance due to tooth tissue and alveolar bone.

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After PDL anesthesia the needles surgical edge have demonstrated upright
bend in 30%. Reverse bend 20%, form-of-U bend 40%, absence of
deformation in 10%. Lower percentage of form-of-U bendexposes a large
wearing qualities of this needle type. Bevel like surgical edge is shorter than
regular bevel and less undergo a deformation. After intraseptal anesthesia
needles (Nipro) with regular bevel had upright bend in 28,6% (fig.4), reverse
bend 28,6%, form-of-U bend 42,9%, absence of deformation was not
revealed. Regular bevel of needles (Uniject) have shown form-of-U bend in
91,7% (fig.5), upright bend, reverse bend and absence of deformation were not
found out.

Fig.4: Needle deformed tip as upright bend after intraseptal anesthesia of 32 tooth.
Regular bevel. Photo. Microscope magnification 40.


Fig.5: Needle deformed tip as form-of-U bend after intraseptal anesthesia of 36 tooth.
Regular bevel. Photo. Microscope magnification 40.

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After intraseptal anesthesia bevel like surgical edge have shown following
results: upright bend 11,1%, reverse bend 11,1%, form-of-U bend 66,7%,
absence of deformation 11,1%.
CONCLUSION:
During PDL anesthesia surgical edge needles have less tip deformation (form-of-
U bend 40%) than needles with regular bevel (form-of-U bend 77,8%).
When performing intraseptal anestesia a deformation degree does not differ
between themselves (p0.01) (surgical edge 66,7%, regular bevel 67,3%).
There were no differences in needles tip deformation between anesthesia in single-
rooted tooth and multirooted tooth.
REFERENCES:
1.Rout P.G.J., Saksena A., Fisher S.E. An Investigation of the Effect on 27-gauge Needle Tips
following a Single Local Anaesthetic Injection Dental Update September 2003
2.Stacy G.C., Hajjar G. Barbed needle and inexplicable paraesthesias and trismus after dental
regional anaesthesia. Oral Surg Oral Med Oral Pathol 1994: 77: 585599.
3.Steele A.C., German M.J., Haas J., Lambert G., Meechan J.G. An in vitro investigation of the
effect of bevel design on the penetration and withdrawal forces of dental
needles.Journalofdentistry, 41 2013:164 169.

Acknowledgement- None
Source of Funding- Nil
Conflict of Interest- None Declared
Ethical Approval- Not Required
Correspondence Addresses :
Dr A.V.Kuzin PHD
143900 Moscow region,
Balaschikha, Lenin str. 15/7 - 27.
Email id- polev_gor @mail.ru

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