Intraseptal and Periodontal Ligament Anaesthesia for Tooth Extraction in Patients With Type 2 Diabetes
Efficacy and Safety of Intraseptal and Periodontal Ligament Anaesthesia for Extraction of Upper Lateral Incisors and Lower First Premolars in Patients With Type 2 Diabetes Mellitus
The goal of this clinical trial is to compare two local anesthesia techniques, intraseptal anesthesia (ISA) and periodontal ligament anesthesia (PLA), in patients with controlled type 2 diabetes mellitus undergoing tooth extraction.
The main questions it aims to answer are:
Which technique provides more effective local anesthesia for tooth extraction? Do ISA and PLA differ in their effects on blood pressure and heart rate during the procedure?
Researchers will compare ISA and PLA to determine which method is more effective and safer in this patient population.
Participants will:
Receive local anesthesia (ISA or PLA) using articaine with epinephrine delivered with a computer-controlled system Undergo extraction of a maxillary lateral incisor or mandibular first premolar Have blood pressure and heart rate measured before, during, and after anesthesia and extraction
Studie Overzicht
Toestand
Conditie
Interventie / Behandeling
Gedetailleerde beschrijving
This randomized clinical trial was designed to evaluate and compare the clinical efficacy and safety of intraseptal anesthesia (ISA) and periodontal ligament anesthesia (PLA) in patients with controlled type 2 diabetes mellitus undergoing tooth extraction.
Local anesthetic administration in diabetic patients requires careful consideration due to potential cardiovascular responses and altered tissue sensitivity. Alternative injection techniques such as ISA and PLA may provide effective anesthesia while minimizing systemic effects.
A total of 120 participants were randomly assigned to receive either ISA or PLA. All anesthetic procedures were performed using a computer-controlled local anesthetic delivery system (CCLADS) with 0.6 mL of 4% articaine with 1:100,000 epinephrine (Septanest).
The study included extraction of maxillary lateral incisors and mandibular first premolars. Outcomes included anesthetic success rate, onset time, duration and extent of anesthesia, as well as changes in systolic and diastolic blood pressure, mean arterial pressure, and heart rate measured before, during, and after the procedure.
Studietype
Inschrijving (Werkelijk)
Fase
- Niet toepasbaar
Contacten en locaties
Studie Locaties
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Vojvodina
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Pančevo, Vojvodina, Servië
- Faculty of Dentistry in Pančevo, University of Business Academy in Novi Sad
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Deelname Criteria
Geschiktheidscriteria
Leeftijden die in aanmerking komen voor studie
- Volwassen
- Oudere volwassene
Accepteert gezonde vrijwilligers
Beschrijving
Inclusion Criteria:
- Controlled Type 2 diabetes mellitus
- Age 35-77 years
- Patients requiring extraction of maxillary lateral incisors or mandibular first premolars
- Teeth free of acute periodontal disease
- No acute dentoalveolar abscess
- No dental treatment within last 48 hours
- No smoking
- No alcohol or drug dependence
- No contraindications to local anesthetic or vasoconstrictor
Exclusion Criteria:
- Smokers
- Patients with alcohol or drug dependence
- Contraindications to local anesthetics or vasoconstrictors
- Acute periodontal disease at the site of injection
- Acute dentoalveolar abscess
- History of tooth trauma or hypersensitivity in target teeth
- Dental treatment within the last 48 hours prior to procedure
- Non-controlled diabetes mellitus (implied, since study includes controlled DM only
Studie plan
Hoe is de studie opgezet?
Ontwerpdetails
- Primair doel: Behandeling
- Toewijzing: Gerandomiseerd
- Interventioneel model: Parallelle opdracht
- Masker: Geen (open label)
Wapens en interventies
Deelnemersgroep / Arm |
Interventie / Behandeling |
|---|---|
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Experimenteel: ISA (Intraseptal Anaesthesia)
Participants received intraseptal anaesthesia using 0.6 mL of 4% articaine with 1:100,000 epinephrine administered via a computer-controlled local anesthetic delivery system (CCLADS) during extraction of maxillary lateral incisors or mandibular first premolars.
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0.6 mL of 4% articaine with 1:100,000 epinephrine administered for intraseptal anaesthesia (ISA) using a computer-controlled local anesthetic delivery system (CCLADS) during extraction of maxillary lateral incisors or mandibular first premolars.
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Experimenteel: PLA (Periodontal Ligament Anaesthesia)
Participants received periodontal ligament anaesthesia using 0.6 mL of 4% articaine with 1:100,000 epinephrine administered via a computer-controlled local anesthetic delivery system (CCLADS) during extraction of maxillary lateral incisors or mandibular first premolars.
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0.6 mL of 4% articaine with 1:100,000 epinephrine administered for periodontal ligament anaesthesia (PLA) using a computer-controlled local anesthetic delivery system (CCLADS) during extraction of maxillary lateral incisors or mandibular first premolars.
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Wat meet het onderzoek?
Primaire uitkomstmaten
Uitkomstmaat |
Maatregel Beschrijving |
Tijdsspanne |
|---|---|---|
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Anesthetic success rate
Tijdsspanne: During tooth extraction procedure (5 minutes after administration of local anaesthesia).
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Anesthetic success rate of intraseptal anaesthesia (ISA) compared with periodontal ligament anaesthesia (PLA) during extraction of maxillary lateral incisors and mandibular first premolars in patients with controlled Type 2 diabetes mellitus.
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During tooth extraction procedure (5 minutes after administration of local anaesthesia).
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Secundaire uitkomstmaten
Uitkomstmaat |
Maatregel Beschrijving |
Tijdsspanne |
|---|---|---|
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Onset time of local anesthesia
Tijdsspanne: Immediately after administration of local anesthesia (during procedure)
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Time from completion of anesthetic injection to the establishment of profound anesthesia in adjacent gingival tissue.
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Immediately after administration of local anesthesia (during procedure)
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Duration of soft tissue anesthesia
Tijdsspanne: During and after procedure (measured at 5-minute intervals until sensation returns)
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Time period from onset of anesthesia until return of sensation confirmed by pinprick testing in buccal attached gingiva.
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During and after procedure (measured at 5-minute intervals until sensation returns)
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Width of anesthetic field
Tijdsspanne: 10 minutes after successful anesthesia
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Extent (in millimeters) of anesthetized area in buccal/lingual/palatal attached gingiva and oral mucosa measured using pinprick testing and a flexible ruler.
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10 minutes after successful anesthesia
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Systolic blood pressure changes
Tijdsspanne: Baseline, during injection, and 5, 10, 15, and 30 minutes post-injection
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Changes in systolic blood pressure before, during, and after administration of local anesthesia.
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Baseline, during injection, and 5, 10, 15, and 30 minutes post-injection
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Diastolic blood pressure changes
Tijdsspanne: Baseline, during injection, and 5, 10, 15, and 30 minutes post-injection
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Changes in diastolic blood pressure during perioperative period of anesthesia administration.
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Baseline, during injection, and 5, 10, 15, and 30 minutes post-injection
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Mean arterial pressure changes
Tijdsspanne: Baseline to 30 minutes post-injection
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Changes in mean arterial pressure during and after administration of local anesthesia.
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Baseline to 30 minutes post-injection
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Heart rate changes
Tijdsspanne: Baseline, during injection, and 5, 10, 15, 30 minutes after administration
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Changes in heart rate during and after administration of local anesthesia using ECG monitoring.
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Baseline, during injection, and 5, 10, 15, 30 minutes after administration
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Medewerkers en onderzoekers
Onderzoekers
- Hoofdonderzoeker: Vladimir Biocanin, Faculty of Dentistry in Pancevo, Department of Oral Surgery, University of Business Academy in Novi Sad, Serbia
Studie record data
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Primaire voltooiing (Werkelijk)
Studie voltooiing (Werkelijk)
Studieregistratiedata
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Eerst ingediend dat voldeed aan de QC-criteria
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Meer informatie
Termen gerelateerd aan deze studie
Trefwoorden
Aanvullende relevante MeSH-voorwaarden
Andere studie-ID-nummers
- No.36/3
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