רפואת הפה והשיניים - עיתון ההסתדרות לרפואת שיניים בישראל - כרך ל"ח, גיליון מס' 1 שבט תשפ"א - ינואר 2021

Table 4: Use of solutions volumes characterized by different factors

Volume 0.90±0.57ml 1.34±0.46ml 0.8±0.5ml 1.06±0.5ml 2.18ml 1.8ml 0.58±0.48ml 0.98±0.54ml 1.46±.55ml

P p>0.05

Local infiltration Block

With N2O W/O N2O Lidocaine 2% + Epinephrine 1:10000

P<0.001 P<0.001 p<0.005.

Mepivacaine 3% Anterior segment Posterior segment Needle Diameter SPDs & RPDs GPs

30G 25G 27G

0.51ml ±0.97 0.36ml±0.61 0.786/0.746±0.4ml 1.65 ±0.3ml

P<0.001

p<0.001

significantly less than that injected in the lower jaw 0.90±0.57ml Vs 1.34±0.46ml (P<0.05). When inhalation sedation was used, less anesthetic solution was injected (0.8±0.5ml with N 2 O/O 2 2Vs 1.09±0.5ml without). The use of 3% mepivacaine solution was significantly higher in the SPDs/RPDs group compared to GPs group - 22% of the treatments Vs 2% (P<0.001). Discussion Local anesthesia for dental treatment in children is one of the most important steps for achieving cooperative behavior during treatment and for positive reaction after treatment. There are no specific guidelines regarding the minimal amount of local anesthesia solution to be injected in children. We know the maximal amount to be injected by weight and we know that the success rate of good anesthesia differs

with regards to the jaw to be treated and the injection technique used (18, 27). The maximal amount of injected solution is well established by weight and the success rate of good anesthesia differs with regards to the jaw to be treated and the injection technique used (18, 27). The amount of local anesthetic solution injected has to be suitable to complete the treatment in a positive way and to reduce the time of post-treatment numbness, in order to minimize the possibility of self-inducted trauma (27). For local anesthesia in adults some recommendations were published: 1-1.5ml for mandibular block (28,29) and 0.5-2.0ml for local infiltration (3). In young children the bone density is reduced and the diffusion rate is higher (3) and the amount of local anesthetic solution can be reduced. SPDs and RDPs injected less than half of the amount of local anesthetic solution than GPs that

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The Journal of the Israel Dental Association, vol. 38, No. 1, January 2021.