Mechanical strain to maxillary incisors during direct laryngoscopy

نویسندگان

  • Milo Engoren
  • Lauryn R Rochlen
  • Matthew V Diehl
  • Sarah S Sherman
  • Elizabeth Jewell
  • Mary Golinski
  • Paul Begeman
  • John M Cavanaugh
چکیده

BACKGROUND While most Direct laryngoscopy leads to dental injury in 25-39% of cases. Dental injury occurs when the forces and impacts applied to the teeth exceed the ability of the structures to dissipate energy and stress. The purpose of this study was to measure strain, (which is the change produced in the length of the tooth by a force applied to the tooth) strain rate, and strain-time integral to the maxillary incisors and determine if they varied by experience, type of blade, or use of an alcohol protective pad (APP). METHODS A mannequin head designed to teach and test intubation was instrumented with eight single axis strain gauges placed on the four maxillary incisors: four on the facial or front surface of the incisors and four on the lingual or back, near the insertion of the incisor in the gums to measure bending strain as well as compression. Anesthesiology faculty, residents, and certified registered nurse anesthetists intubated with Macintosh and Miller blades with and without APP. Using strain-time curves, the maximum strain, strain rate, and strain time integral were calculated. RESULTS Across the 92 subjects, strain varied 8-12 fold between the 25th and 75th percentiles for all four techniques, but little by experience, while strain rate and strain integral varied 6-13 fold and 15-26 fold, respectively, for the same percentiles. Intubators who had high strain values with one blade tended to have high strains with the other blade with and without the APP (all pairwise correlation rho = 0.42-0.63). CONCLUSIONS Strain varies widely by intubator and that the use of the APP reduces strain rate which may decrease the risk of or the severity of dental injury.

برای دانلود رایگان متن کامل این مقاله و بیش از 32 میلیون مقاله دیگر ابتدا ثبت نام کنید

ثبت نام

اگر عضو سایت هستید لطفا وارد حساب کاربری خود شوید

منابع مشابه

Forces acting on the maxillary incisor teeth during laryngoscopy using the Macintosh laryngoscope.

We determined the forces on the maxillary incisors during routine laryngoscopy in 65 adult patients. The forces were measured by a strain gauge based sensor positioned between the handle and the blade of the laryngoscope. The mean maximal force acting on the maxillary incisors was 49 N. In patients without maxillary incisors, the force acting on the gums was significantly lower at 21 N (p < 0.0...

متن کامل

Does experience influence the forces exerted on maxillary incisors during laryngoscopy? A manikin study using the Macintosh laryngoscope.

The influence of the level of experience of the laryngoscopist on the duration of laryngoscopy, the forces exerted on the tongue and on the maxillary incisors during laryngoscopy, were investigated. Five groups (anaesthetists, residents in anaesthesia, nurse anaesthetists, surgeons and medical students), each consisting of 15 individuals, participated in the study. An intubation manikin was use...

متن کامل

Prevention of dental damage and improvement of difficult intubation using a paraglossal technique with a straight Miller blade.

Patients with diseased teeth, or those who are difficult to intubate, have a higher risk of dental injury during laryngoscopy. We report 3 cases of smooth endotracheal intubation using a paraglossal technique with a straight Miller blade in patients with poor dentition. Three patients with poor dentition were scheduled to undergo surgery under general anesthesia. All patients presented with ext...

متن کامل

بررسی تغییرات طول ریشه دندانهای ثنایای بالا در دوران ریتنشن ارتودنسی1

Background and Aim: External apical root resorption is a common iatrogenic consequence of orthodontic treatment. Much controversy exists in the literature about changes in root lengths at post treatment periods. Although many practitioners believe that resorption becomes stable after active treatment, quantitative data are scarce. The purpose of this study was to determine quantitative changes ...

متن کامل

Bilateral supernumerary maxillary lateral incisors: A rare case report

BACKGROUND AND AIM: Supernumerary tooth (ST) is considered as a developmental tooth abnormality in number that most often occurs in the anterior region of the maxilla. They may erupt or remain impacted in the alveolar bone. The impacted teeth can cause eruptional disturbances for the adjacent developing teeth. CASE REPORT: A case of bilateral supplemental maxillary lateral incisors in a nonsynd...

متن کامل

ذخیره در منابع من


  با ذخیره ی این منبع در منابع من، دسترسی به آن را برای استفاده های بعدی آسان تر کنید

عنوان ژورنال:

دوره 17  شماره 

صفحات  -

تاریخ انتشار 2017