Needle-free Mental Incisive Nerve Block: In vitro, Cadaveric, and Pilot Clinical Studies

Qiman Gao, Anna Henley, Geoffroy Noël, Zovinar Der Khatchadourian, Doaa Taqi, Mohammad Abusamak, Zixin He, Swen Grœn, Rani Taher, Karim Menassa, Ana Velly, Elham Emami, Luc Mongeau, Faleh Tamimi

Research output: Contribution to journalArticlepeer-review

1 Scopus citations

Abstract

The present study aimed to optimize Needle-Free Liquid Jet Injection (NFLJI) for Mental Incisive Nerve Blocks (MINB) and evaluate its clinical safety and feasibility. A MINB protocol was developed and optimized by series of NFLJI experiments in soft tissue phantoms and cadavers, then validated in two pilot Randomized Controlled Trials (RCT). The NFLJI penetration depth was found to be directly proportional to the supply pressure and volume. High-pressure NFLJIs (620 kPa or above) created maximum force and total work significantly greater than needle injections. Low-pressure NFLJIs (413 kPa), however, produced results similar to those of needle injections. Additionally, high-pressure NFLJIs created jet impingement pressure and maximum jet penetration pressure higher than low-pressure NFLJIs. Pilot RCTs revealed that high-pressure NFLJI caused a high risk of discomfort (60%) and paresthesia (20%); meanwhile, low-pressure NFLJI was less likely to cause complications (0%). The preliminary success rates of MINB from cadavers using NFLJIs and needles were 83.3% and 87.5%. In comparison, those from RCTs are 60% and 70%, respectively. To conclude, NFLJI supply pressure can be adjusted to achieve effective MINB with minimal complications. Furthermore, the cadaver study and pilot RCTs confirmed the feasibility for further non-inferiority RCT.

Original languageEnglish (US)
Article number121197
JournalInternational journal of pharmaceutics
Volume609
DOIs
StatePublished - Nov 20 2021
Externally publishedYes

Bibliographical note

Funding Information:
This research was sponsored by Canada's Natural Sciences and Engineering Research Council (543972-19 and 366077487). Partial support from the National Institutes of Health (NIH) Grant R01 DC0R01DC018577 (Mongeau, PI) is also acknowledged. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. The first author is sponsored by the Clifford C.F. Wong Fellowship, réseau de Recherche en Santé Buccodentaire et Osseuse, and Alpha-OmegaFoundation of Canada from McGill University and the Doctoral fellowship from the Chinese Scholarship Council.

Funding Information:
We sincerely thank Robert L'Heureux B.S. Jamie Brisebois B.S. from the Department of cell and anatomy, McGill University, for organizing the cadaver experiments. We also appreciate the generosity of the body donors and their families. Our gratitude further extends to Nathalie Morin DDS, Rosa Menale DA, Ann Marie Plante DA from Faculty of Dentistry, McGill University for organizing the clinical trials, Dr. Entisar Abdulkader, Dr. Guangyu Bao and Dr. Ammar Alsheghri for the consultation, and Ms. Joan O'Malley for the photo studio. This research was sponsored by Canada's Natural Sciences and Engineering Research Council (543972-19 and 366077487). Partial support from the National Institutes of Health (NIH) Grant R01 DC0R01DC018577 (Mongeau, PI) is also acknowledged. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. The first author is sponsored by the Clifford C.F. Wong Fellowship, r?seau de Recherche en Sant? Buccodentaire et Osseuse, and Alpha-OmegaFoundation of Canada from McGill University and the Doctoral fellowship from the Chinese Scholarship Council.

Publisher Copyright:
© 2021 The Authors

Keywords

  • Dental anesthesia
  • Feasibility studies
  • Jet injections
  • Mental nerve
  • Paresthesia
  • Pilot studies
  • Randomized controlled trial

PubMed: MeSH publication types

  • Journal Article

Fingerprint

Dive into the research topics of 'Needle-free Mental Incisive Nerve Block: In vitro, Cadaveric, and Pilot Clinical Studies'. Together they form a unique fingerprint.

Cite this