Evidence map›Paper›PMID 39473049›Full record

ArticleJournal of dental education2025

Evaluation of dental students' learning curve in intraligamentary anesthesia using different syringe systems: A prospective crossover study.

Philipp Luhrenberg, Mirjam Renders, Diana Heimes, Anke Hollinderbäumer, Sebahat Kaya, Solomiya Kyyak, Saskia V Schröger, Daniel G E Thiem, Helen Wagner, Peer W Kämmerer

Abstract read
In one paragraph

Article in Journal of dental education, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Philipp LuhrenbergDepartment of Oral and Maxillofacial Surgery, Facial Plastic Surgery, University Medical Center, Johannes Gutenberg University Mainz, Mainz, Germany.
Mirjam RendersDepartment of Oral and Maxillofacial Surgery, Facial Plastic Surgery, University Medical Center, Johannes Gutenberg University Mainz, Mainz, Germany.
Diana HeimesDepartment of Oral and Maxillofacial Surgery, Facial Plastic Surgery, University Medical Center, Johannes Gutenberg University Mainz, Mainz, Germany.
Anke HollinderbäumerDepartment of Oral and Maxillofacial Surgery, Facial Plastic Surgery, University Medical Center, Johannes Gutenberg University Mainz, Mainz, Germany.
Sebahat KayaDepartment of Oral and Maxillofacial Surgery, Facial Plastic Surgery, University Medical Center, Johannes Gutenberg University Mainz, Mainz, Germany.
Solomiya KyyakDepartment of Oral and Maxillofacial Surgery, Facial Plastic Surgery, University Medical Center, Johannes Gutenberg University Mainz, Mainz, Germany.
Saskia V SchrögerDepartment of Oral and Maxillofacial Surgery, Facial Plastic Surgery, University Medical Center, Johannes Gutenberg University Mainz, Mainz, Germany.
Daniel G E ThiemDepartment of Oral and Maxillofacial Surgery, Facial Plastic Surgery, University Medical Center, Johannes Gutenberg University Mainz, Mainz, Germany.
Helen WagnerDepartment of Oral and Maxillofacial Surgery, Facial Plastic Surgery, University Medical Center, Johannes Gutenberg University Mainz, Mainz, Germany.
Peer W KämmererDepartment of Oral and Maxillofacial Surgery, Facial Plastic Surgery, University Medical Center, Johannes Gutenberg University Mainz, Mainz, Germany.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

PURPOSE/

objectivesThis prospective crossover preclinical trial aimed to evaluate the learning curve of dental students in successfully administering intraligamentary anesthesia (ILA) using three different syringe systems.

methodsDental students performed ILA using three devices in two separate sessions, each targeting mandibular and/or maxillary premolars. The devices included two manual systems (pistol-type and lever-based) and one computer-controlled local anesthetic delivery system (CCLAD). The primary research parameter was the success rate of anesthesia, defined as the percentage of successful ILA administrations confirmed by a negative response to a cold test. Secondary parameters included pain experienced during needle penetration and injection, students' self-reported levels of mental tension and handling of the syringes, and any potential side effects.

resultsA total of 110 students performed ILA on 599 teeth during the study period. When comparing the CCLAD system to the manual syringes, the CCLAD system exhibited a significantly higher overall success rate in the first session (92.5% vs. 77.4%; p < 0.001), potentially due to its precise control of anesthetic flow and pressure, which likely facilitated more effective anesthetic delivery. However, when examining the individual manual techniques, no significant difference was found between the pistol-type manual and the CCLAD system (p = 0.66). All techniques' success rate increased from the first to the second session (80.4% vs. 86.9%; p = 0.0357). Additionally, penetration pain demonstrated a significant decrease across all techniques (p < 0.01). Notably, students' anxiety levels decreased, and self-assurance increased significantly over the sessions. Undesired reversible side effects were documented in 10.9% of cases.

conclusionThese findings suggest that repeated practice of ILA, particularly with different syringe systems, enhances anesthetic success and psychological readiness for patient interaction. Additional training sessions may further improve proficiency.

Indexed as

Anesthesia, DentalAnesthesia, LocalAnesthetics, LocalEducation, DentalLearning CurveStudents, DentalSyringesClinical CompetenceCross-Over StudiesFemaleHumansMaleProspective StudiesAnesthetics, Localacademic trainingCCLADclinical skillsdental anesthesiaeducationalintraligamentary anesthesia

Identifiers

PMID39473049
PMCPMC12004350

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.