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Efficacy and Reliability of Single Tooth Anesthesia (STA) for Surgical Removal of Impacted Wisdom Teeth: A Comparative Study

  • COMPARATIVE STUDY
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Abstract

Introduction

Single tooth anesthesia via intra-ligamentary injections has long been used to provide localized pain control with minimal discomfort while avoiding undesirable effects like lip numbness, mainly in pediatric population with definite success. In this study, we aimed to assess the efficacy of single tooth anesthesia (STA) via intra-ligamentary injections using WAND® STA in the surgical removal of impacted third molar.

Methodology

Sixty patients were randomly divided into two groups of 30 each where Group I (study group) received local anesthesia via STA system with 4% articaine and Group II (control group) received conventional injection, that is, inferior alveolar nerve block, (IANB) with 4% articaine. Assessment of the effectiveness of the anesthesia was made by noting the onset of action, failure of anesthesia, intra-operative pain and necessity for additional injection. Additional effects such as lip numbness were also noted. Patients were evaluated for pain and discomfort after 24 h.

Results

The difference between the mean time for onset of action for STA injections and conventional block and the mean difference in the onset of action between both groups was 2.2 (± 0.25) minutes which was statistically significant (p < 0.05). Statistically significant difference in VAS score was noted only during tooth elevation with Group I reporting higher VAS score than Group II. Additional blocks were indicated in 6.7% for lingual block and 50% for long buccal nerve block in Group I and repetition of long buccal nerve block was indicated in 23.3% patients in group II. Postoperative pain and trismus was found to be higher in Group II.

Conclusion

In spite of some limits in the extent of anesthesia achieved, WAND® STA was seen to be able to achieve adequate anesthesia for surgical removal of impacted third molar and is a viable alternative, particularly in patients where blocks are contraindicated due to systemic conditions.

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Abbreviations

STA:

Single tooth anesthesia

CCS:

Computer controlled syringes

CCLAD:

Computer controlled local anesthetic delivery system

EDA:

Electronic dental anesthesia

DPS:

Dynamic pressure sensing technology

PDL:

Periodontal ligament

AMSA:

Anterior middle superior alveolar block

TMS:

Traditional multiple supraperiosteal injections

P-ASA:

Palatal approach anterior superior alveolar nerve block

NRS:

Numeric rating scale

VRS:

Visual analogue scale

IAN:

Inferior alveolar nerve

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Acknowledgements

The authors would like to thank the Meenakshi Academy of Higher Education and Research, Chennai, Tamil Nadu, India, for constant support to carry out our research project.

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Authors and Affiliations

  1. Department of Oral & Maxillofacial Surgery, Meenakshi Cleft & Craniofacial Center, Meenakshi Ammal Dental College & Hospital, MAHER University, Maduravoyal, Chennai, 600095, India

    Manikandhan Ramanathan

  2. Apollo Spectra Hospital, Hyderabad, India

    Sandeep Ramanuj

  3. Department of Oral & Maxillofacial Surgery, Meenakshi Ammal Dental College & Hospital, MAHER University, Maduravoyal, Chennai, 600095, India

    Keerthana Ponvel

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  1. Manikandhan Ramanathan
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  3. Keerthana Ponvel
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Correspondence to Manikandhan Ramanathan.

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Ramanathan, M., Ramanuj, S. & Ponvel, K. Efficacy and Reliability of Single Tooth Anesthesia (STA) for Surgical Removal of Impacted Wisdom Teeth: A Comparative Study. J. Maxillofac. Oral Surg. 23, 88–96 (2024). https://doi.org/10.1007/s12663-023-02017-z

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