DOI QR코드

DOI QR Code

Physical, chemical, mechanical, and micromorphological characterization of dental needles

  • Received : 2021.02.08
  • Accepted : 2021.03.08
  • Published : 2021.04.01

Abstract

Background: In anesthetic techniques, touching bones can cause needle bending. Theoretically, a needle should support such deflection without fracturing. However, it is possible that a needle may fracture depending on the quality and type of needle used. This study evaluated the physical, chemical, and micromorphological characteristics of long and short dental anesthetic needles, as well as the mechanical properties of flexural load and bending resistance when needles are subjected to different bending angles. Methods: Long and short needles (30G, Jets, Misawa, Selekto, Terumo, Unoject and 27G, Dencojet, Injex, Jets, Misawa, Procare, Setoject XL, Terumo) were evaluated. Scanning electron microscopy was used to evaluate the needle bevels and energy-dispersive X-ray spectroscopy was used for the chemical analysis of needle compositions. Flexural loading and bending strength assessments were performed using a universal testing machine by bending the needles (n = 5) to angles of 30°, 60°, or 90°, or until fracture occurred. Results: The Injex 27G, Jets 27G, and Septoject XL 27G needles were all less than 30 mm in length. There were small percentage variations in the chemical compositions of the needles. Superior smoothness was observed for the Unoject 30G needle, which exhibited the highest fracture resistance at 60°. The Jets 30G needle exhibited greater resistance to fractures at 90°. The Procare 27G needle exhibited the highest load resistance to bending, followed by the Septoject XL 27G needle, and both needles were tied for the lowest fracture resistance. No needle fractured when bent to 30° or at less than three bends to 60° or 90°. Conclusions: Greater needle resistance to bending increases the probability of early fracturing. Thinner and shorter needles are more resistant than longer and thicker needles. Performing a single bend does not result in any significant risk of fracture or obliterate the lumen, allowing for the continued passage of anesthetic liquid.

Keywords

References

  1. Stein KM. Use of intraoperative navigation for minimally invasive retrieval of a broken dental needle. J Oral Maxillofac Surg 2015; 73: 1911-6. https://doi.org/10.1016/j.joms.2015.04.033
  2. Philbert R, Hamilton B, Zola M. Management of needle breakage using intraoperative navigation following inferior nerve block. J Oral Maxillofac Surg 2014; 72: 653. https://doi.org/10.1016/j.joms.2013.12.023
  3. Gerbino G, Zavattero E, Berrone M, Berrone S. Management of needle breakage using intraoperative navigation following inferior nerve block. J Oral Maxillofac Surg 2013; 71: 1819-24. https://doi.org/10.1016/j.joms.2013.07.023
  4. Malamed SF. Handbook of local anesthesia. 6th ed. St Louis, Elsevier Mosby. 2013.
  5. ANSI/ADA specification no. 54 for double-pointed, parenteral, singleuse needles for dentistry. Council on dental materials, instruments, and equipment. J Am Dent Assoc 1986; 113: 952. https://doi.org/10.14219/jada.archive.1986.0285
  6. International Organization for Standardization. ISO 7885: Sterile, single-use dental injection needle. Genova; 1996.
  7. Robison SF, Mayhew RB, Cowan RD, Hawley RJ. Comparative study of deflection characteristics and fragility of 25-, 27-, and 30-gauge short dental needles. J Am Dent Assoc 1984; 109: 920-4. https://doi.org/10.14219/jada.archive.1984.0246
  8. Marks RB, Carlton DM, McDonald S. Management of a broken needle in the pterygomandibular space: report of a case. J Am Dent Assoc 1984; 109: 263-4. https://doi.org/10.14219/jada.archive.1984.0355
  9. McDonough T. An unusual case of trismus and dysphagia. Br Dent J 1996; 180: 465-6. https://doi.org/10.1038/sj.bdj.4809128
  10. Bhatia S, Bounds G. A broken needle in the pterygomandibular space: report of a case and review of the literature. Dent Update 1998; 25: 35-7.
  11. Bedrock RD, Skigen A, Dolwick MF. Retrieval of a broken needle in the pterygomandibular space. J Am Dent Assoc 1999; 130: 685-7. https://doi.org/10.14219/jada.archive.1999.0278
  12. Faura-Sole M, Sanchez-Garces MA, Berini-Aytes L, Gay-Escoda C. Broken anaesthetic injection needles: report of 5 cases. Quintessence Int 1999; 30: 461-5.
  13. Zeltser R, Cohen C, Casap N. The implications of a broken needle in the pterygomandibular space: clinical guidelines for prevention and retrieval. Pediatr Dent 2002; 24: 153-6.
  14. Park SS, Yang HJ, Lee UL, Kwon MS, Kim MJ, Lee JH, et al. The clinical application of the dental mini C-arm for the removal of broken instruments in soft and hart tissue in the oral and maxillofacial area. J Craniomaxillofac Surg 2012; 40: 572-8. https://doi.org/10.1016/j.jcms.2011.10.013
  15. Lee TY, Zaid WS. Broken dental needle retrieval using a surgical navigation system: a case report and literature review. Oral Surg Oral Med Oral Pathol Oral Radiol 2015; 119: e55-9.
  16. Thompson M, Wright S, Cheng LH, Starr D. Locating broken dental needles. Int J Oral Maxillofac Surg 2003; 32: 642-4. https://doi.org/10.1054/ijom.2003.0430
  17. Ethunandan M, Tran AL, Anand R, Bowden J, Seal MT, Brennan PA. Needle breakage following inferior alveolar nerve block: implications and management. Br Dent J 2007; 202: 395-7. https://doi.org/10.1038/bdj.2007.272
  18. Augello M, von Jackowski J, Gratz KW, Jacobsen C. Needle breakage during local anesthesia in the oral cavity - a retrospective of the last 50 years with guidelines for treatment and prevention. Clin Oral Investig 2011; 15: 3-8. https://doi.org/10.1007/s00784-010-0442-6
  19. Acham S, Truschnegg A, Rugani P, Kirnbauer B, Reinbacher KE, Zemann W, et al. Needle fracture as a complication of dental local anesthesia: recommendations for prevention and a comprehensive treatment algorithm based on literature from the past four decades. Clin Oral Investig 2019; 23: 1109-19. https://doi.org/10.1007/s00784-018-2525-8
  20. R Core Team. R. A language and environment for statistical computing. Vienna: R Foundation for Statistical Computing; 2020.
  21. Dau M, Buttchereit I, Ganz C, Frerich B, Anisimova EN, Daublander M, et al. Influence of needle bevel design on injection pain and needle deformation in dental local infiltration anaesthesia - randomized clinical trial. Int J Oral Maxillofac Surg 2017; 46: 1484-9. https://doi.org/10.1016/j.ijom.2017.06.013
  22. Van den Akker HP, Baart JA. Local complications - needle breakage. In: Local anaesthesia in dentistry. 2nd ed. Edited by Baart JA, Brand HS. Switzerland, Springer International Publishing. 2017, pp 147-59
  23. Normando D, de Almeida Santos HG, Abdo Quintao CC. Comparisons of tooth sizes, dental arch dimensions, tooth wear, and dental crowding in Amazonian indigenous people. Am J Orthod Dentofacial Orthop 2016; 150: 839-46. https://doi.org/10.1016/j.ajodo.2016.03.033
  24. Pogrel MA. Broken local anesthetic needles: a case series of 16 patients, with recommendations. J Am Dent Assoc 2009; 140: 1517-22. https://doi.org/10.14219/jada.archive.2009.0103
  25. Casey JT, Lupo JE, Jenkins HA. Retained dental needle migration across the skull base to the cochlea presenting as hearing loss. Otol Neurotol 2015; 36: e42-5. https://doi.org/10.1097/MAO.0000000000000690
  26. Brooks J, Murphy MT. A novel case of a broken dental anesthetic needle transecting the right internal carotid artery. J Am Dent Assoc 2016; 147: 739-42. https://doi.org/10.1016/j.adaj.2016.03.014
  27. Okumura Y, Hidaka H, Seiji K, Nomura K, Takata Y, Suzuki T, et al. Unique migration of a dental needle into the parapharyngeal space: successful removal by an intraoral approach and simulation for tracking visibility in X-ray fluoroscopy. Ann Otol Rhinol Laryngol 2015; 124: 162-7. https://doi.org/10.1177/0003489414547106
  28. Queiroz SB, Lima VN, Amorim PH, Magro-Filho O, Amorim RF. Retrieval of a broken dental needle close to the facial artery after cervical migration. J Craniofac Surg 2016; 27: e338-40. https://doi.org/10.1097/SCS.0000000000002507
  29. Lippold JC, Kotecki DJ. Welding metallurgy and weldability of stainless steels. Hoboken: John Wiley & Sons; 2005.
  30. McPherson JS, Dixon SA, Townsend R, Vandewalle KS. Effect of needle design on pain from dental local anesthetic injections. Anesth Prog 2015; 62: 2-7. https://doi.org/10.2344/0003-3006-62.1.2
  31. Anusavice K, Shen C, Rawls HR. Phillips RW. Phillip's Science of Dental Materials. Saint Louis: Saunders; 2012.