Pressures generated in vitro during Stabident intraosseous injections

Area of Science:

• Dental Anesthesiology
• Biomechanical Engineering

Background:

• Intraosseous anesthesia techniques aim for rapid onset and profound anesthesia.
• The Stabident system is an intraosseous injection device requiring specialized perforation.
• Concerns exist regarding potential high-pressure risks and anesthetic cartridge failure with intraosseous methods.

Purpose of the Study:

• To evaluate the hypothesis that the Stabident intraosseous injection technique generates high pressures.
• To assess the risk of anesthetic cartridge failure associated with the Stabident system.
• To quantify intra-cartridge pressures during Stabident injections under various conditions.

Main Methods:

• A modified dental syringe was used to measure local anesthetic cartridge pressures.
• Injections were performed into air and sheep mandible models (young/old) simulating Stabident perforations.
• Both slow (approx. 15s) and rapid (<10s) injection rates of 2% Xylocaine with 1:80,000 adrenaline were tested.
• Pressure data were recorded at 1-second intervals, with statistical analysis including one-way ANOVA.

Main Results:

• Injection pressures were significantly higher when injecting into tissue compared to air (P<0.001).
• Rapid injections generated significantly higher intra-cartridge pressures than slow injections (P<0.05).
• Higher pressures were observed in younger, smaller sheep mandibles compared to older, larger ones. The maximum recorded pressure was 3.31 MPa, below the glass cartridge fracture threshold.

Conclusions:

• Stabident intraosseous injections, when performed according to manufacturer guidelines, do not present a serious risk of dangerous pressure build-up.
• The pressures generated are insufficient to cause local anesthetic cartridge failure.
• The technique is deemed safe concerning anesthetic cartridge integrity.