Is supraperiosteal infltration anesthesia safe enough to prevent inferior alveolar nerve during posterior mandibular implant surgery

Abstract

Objectives: There is no agreement on using inferior alveolar nerve (IAN) block or supraperiosteal infltration anesthesia during dental implant surgery in the posterior mandibular region. The aim of this study was to evaluate the effectiveness of supraperiosteal infltration anesthesia on posterior mandibular region during dental implant surgery. Materials and Methods: In this study 52 implants were inserted under supraperiosteal infltration anesthesia in 29 patients. After the surgery, patients were instructed to note their pain and/or painless dyscomfort on the visual analogue scale (VAS). Their pressure pain threshold (PPT) scores were evaluated by mechanical algometer. The distance between the apical end of the implants and IAN was measured by using calipers on postoperatif panoramic radiographs. Results: 50 implants to 27 patients had been able to place without pain under supraperiosteal infltration. Implants which were placed at the mandibular second premolar and frst molar region had been able to place with free of pain with supraperiosteal infltration. There was no relationship among the distance between the apical ends of the implants and IAN with intraoperative discomfort of the patients. VAS scores during implant placement at the second premolar region were relatively higher than at the frst and second molar region. Conclusion: Supraperiosteal infltration anesthesia is a safe and effective method for posterior mandibular implant surgery. However the length of the implant should be determined carefully to avoid possible damage to IAN during implant placement under supraperiosteal infltration anesthesia. © Medicina Oral S. L. C.I.F.