比较牙周膜无痛麻醉注射和传统手推骨膜上浸润麻醉方法在儿童乳磨牙牙髓切断术中的应用价值。

选择2018年1月至2019年7月于青岛市口腔医院儿童口腔科就诊，年龄为5~ 7岁，下颌双侧第二乳磨牙深龋坏，需进行牙髓切断术治疗的儿童50例，共100颗牙齿。全部患儿一侧下颌第二乳磨牙采用计算机控制口腔局部麻醉系统（STA）牙周膜注射麻醉，对侧下颌第二乳磨牙采用传统手推骨膜上浸润麻醉，以此分为无痛麻醉组和传统麻醉组，各50颗牙齿。采用Wong-Baker面部表情疼痛量表（Wong-Baker量表）评价两组注射时疼痛程度及牙髓切断术中麻醉效果，治疗结束后24 h电话随访评价软组织不适情况。采用χ²检验分别比较注射时、牙髓切断过程中无痛麻醉组和传统麻醉组Wong-Baker量表得分。

注射时，无痛麻醉组无痛或微痛率为88%，较痛或很痛率为12%，传统麻醉组无痛或微痛率为42%，较痛或很痛率为54%，无痛麻醉组要显著低于传统麻醉组，差异有统计学意义（χ²= 23.502，P<0.001）；牙髓切断过程中，无痛麻醉组无痛或微痛率为98%，较痛或很痛率为2%，传统麻醉组无痛或微痛率为96%，较痛或很痛率为4%，经χ²检验，术中无痛麻醉组和传统麻醉组麻醉两者麻醉效果相当，差异无统计学意义（χ²= 0.344，P= 0.57）；术后无痛麻醉组软组织麻木不适的发生率（2%）显著低于传统麻醉组（100%），其中传统麻醉组5例儿童出现自伤性溃疡。

儿童乳磨牙牙髓切断术中，STA系统牙周膜注射麻醉和传统手推骨膜上浸润麻醉两种方法麻醉效果相当，但是STA系统牙周膜注射麻醉较传统手推骨膜上浸润麻醉注射时疼痛程度更轻，术后不适反应更小。

To compare the value of periodontal painless anesthesia injection and traditional hand push supraperiosteal infiltration anesthesia in the pulpotomy of children′s primary molars.

Fifty children aged from 5 to 7 years old who had deep caries in the second deciduous molar on both sides of the lower jaw (total 100 teeth) and needed pulpotomy were selected in the department of pediatric dentistry in Qingdao stomatological hospital from January 2018 to July 2019. All the children were divided into painless anesthesia group and traditional anesthesia group, each with 50 teeth. The painless anesthesia group were anesthetized by using a computer-controlled oral local anesthesia system (STA) for periodontal membrane injection on one side of mandibular second molars. The traditional anesthesia group were anesthetized by traditional hand push supraperiosteal infiltration anesthesia on the contralateral mandibular second molars. The pain severity of injection and efficacy of anesthesia during pulpotomy were evaluated using the Wong-Baker FACES Rating Scale (Wong-Baker) . Soft tissue discomfort was evaluated by telephone follow-up 24 hours after the end of treatment. The Chi-square Test was used for statistical analysis of the Wong-Baker scale scores of the two groups during the injection and the pulpotomy.

In the painless anesthesia group, the painless or mild pain rate was 88%, the relatively painful or severe pain rate was 12%. In the traditional anesthesia group, the painless or mild pain rate was 42%, the relatively painful or severe pain rate was 54% during injection. The pain level in the painless anesthesia group was significantly lower than that in the traditional anesthesia group (χ²= 23.502, P<0.001) . During the pulpotomy, the painless or mild pain rate was 98%, and the relatively painful or severe pain rate was 2% in the painless anesthesia group, and in the traditional anesthesia group, the painless or mild pain rate was 96%, and the relatively painful or severe pain rate was 4%. Chi-square Test results showed that the effect of anesthesia in the painless anesthesia group was similar to that in the traditional anesthesia group, with no significant difference (χ²= 0.344, P= 0.57) . The incidence of soft tissue numbness discomfort in the painless anesthesia group (2%) was significantly lower than that in the traditional anesthesia group (100%) , among which 5 children developed self-injury ulcer.

The STA periodontal membrane injection was as effective as traditional hand push suproperiosteal infiltration anesthesia in anesthetizing the primary mandibular molars during pulpotomy, and rates of postoperative complications were lower with STA when compared to traditional hand push supraperiosteal infiltration anesthesia.