Sensitivity, Specificity, Predictive Values, and Accuracy of Three Diagnostic Tests to Predict Inferior Alveolar Nerve Blockade Failure in Symptomatic Irreversible Pulpitis
Introduction. The inferior alveolar nerve block (IANB) is the most common anesthetic technique used on mandibular teeth during root canal treatment. Its success in the presence of preoperative inflammation is still controversial. The aim of this study was to evaluate the sensitivity, specificity, pr...
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Wiley
2017-01-01
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| Series: | Pain Research and Management |
| Online Access: | http://dx.doi.org/10.1155/2017/3108940 |
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| author | Daniel Chavarría-Bolaños Laura Rodríguez-Wong Danny Noguera-González Vicente Esparza-Villalpando Mauricio Montero-Aguilar Amaury Pozos-Guillén |
| author_facet | Daniel Chavarría-Bolaños Laura Rodríguez-Wong Danny Noguera-González Vicente Esparza-Villalpando Mauricio Montero-Aguilar Amaury Pozos-Guillén |
| author_sort | Daniel Chavarría-Bolaños |
| collection | DOAJ |
| description | Introduction. The inferior alveolar nerve block (IANB) is the most common anesthetic technique used on mandibular teeth during root canal treatment. Its success in the presence of preoperative inflammation is still controversial. The aim of this study was to evaluate the sensitivity, specificity, predictive values, and accuracy of three diagnostic tests used to predict IANB failure in symptomatic irreversible pulpitis (SIP). Methodology. A cross-sectional study was carried out on the mandibular molars of 53 patients with SIP. All patients received a single cartridge of mepivacaine 2% with 1 : 100000 epinephrine using the IANB technique. Three diagnostic clinical tests were performed to detect anesthetic failure. Anesthetic failure was defined as a positive painful response to any of the three tests. Sensitivity, specificity, predictive values, accuracy, and ROC curves were calculated and compared and significant differences were analyzed. Results. IANB failure was determined in 71.7% of the patients. The sensitivity scores for the three tests (lip numbness, the cold stimuli test, and responsiveness during endodontic access) were 0.03, 0.35, and 0.55, respectively, and the specificity score was determined as 1 for all of the tests. Clinically, none of the evaluated tests demonstrated a high enough accuracy (0.30, 0.53, and 0.68 for lip numbness, the cold stimuli test, and responsiveness during endodontic access, resp.). A comparison of the areas under the curve in the ROC analyses showed statistically significant differences between the three tests (p<0.05). Conclusion. None of the analyzed tests demonstrated a high enough accuracy to be considered a reliable diagnostic tool for the prediction of anesthetic failure. |
| format | Article |
| id | doaj-art-829855d4bac74729917e9328e7084dd9 |
| institution | Kabale University |
| issn | 1203-6765 1918-1523 |
| language | English |
| publishDate | 2017-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Pain Research and Management |
| spelling | doaj-art-829855d4bac74729917e9328e7084dd92025-02-03T01:13:12ZengWileyPain Research and Management1203-67651918-15232017-01-01201710.1155/2017/31089403108940Sensitivity, Specificity, Predictive Values, and Accuracy of Three Diagnostic Tests to Predict Inferior Alveolar Nerve Blockade Failure in Symptomatic Irreversible PulpitisDaniel Chavarría-Bolaños0Laura Rodríguez-Wong1Danny Noguera-González2Vicente Esparza-Villalpando3Mauricio Montero-Aguilar4Amaury Pozos-Guillén5Facultad de Odontología, Universidad de Costa Rica, San José, Costa RicaFacultad de Odontología, Universidad de Costa Rica, San José, Costa RicaFacultad de Odontología, Universidad Latina de Costa Rica, San José, Costa RicaDoctorado Institucional en Ingeniería y Ciencia de Materiales, Universidad Autónoma de San Luis Potosí, San Luis Potosí, SLP, MexicoFacultad de Odontología, Universidad de Costa Rica, San José, Costa RicaLaboratorio de Ciencias Básicas, Facultad de Estomatología, Universidad Autónoma de San Luis Potosí, San Luis Potosí, SLP, MexicoIntroduction. The inferior alveolar nerve block (IANB) is the most common anesthetic technique used on mandibular teeth during root canal treatment. Its success in the presence of preoperative inflammation is still controversial. The aim of this study was to evaluate the sensitivity, specificity, predictive values, and accuracy of three diagnostic tests used to predict IANB failure in symptomatic irreversible pulpitis (SIP). Methodology. A cross-sectional study was carried out on the mandibular molars of 53 patients with SIP. All patients received a single cartridge of mepivacaine 2% with 1 : 100000 epinephrine using the IANB technique. Three diagnostic clinical tests were performed to detect anesthetic failure. Anesthetic failure was defined as a positive painful response to any of the three tests. Sensitivity, specificity, predictive values, accuracy, and ROC curves were calculated and compared and significant differences were analyzed. Results. IANB failure was determined in 71.7% of the patients. The sensitivity scores for the three tests (lip numbness, the cold stimuli test, and responsiveness during endodontic access) were 0.03, 0.35, and 0.55, respectively, and the specificity score was determined as 1 for all of the tests. Clinically, none of the evaluated tests demonstrated a high enough accuracy (0.30, 0.53, and 0.68 for lip numbness, the cold stimuli test, and responsiveness during endodontic access, resp.). A comparison of the areas under the curve in the ROC analyses showed statistically significant differences between the three tests (p<0.05). Conclusion. None of the analyzed tests demonstrated a high enough accuracy to be considered a reliable diagnostic tool for the prediction of anesthetic failure.http://dx.doi.org/10.1155/2017/3108940 |
| spellingShingle | Daniel Chavarría-Bolaños Laura Rodríguez-Wong Danny Noguera-González Vicente Esparza-Villalpando Mauricio Montero-Aguilar Amaury Pozos-Guillén Sensitivity, Specificity, Predictive Values, and Accuracy of Three Diagnostic Tests to Predict Inferior Alveolar Nerve Blockade Failure in Symptomatic Irreversible Pulpitis Pain Research and Management |
| title | Sensitivity, Specificity, Predictive Values, and Accuracy of Three Diagnostic Tests to Predict Inferior Alveolar Nerve Blockade Failure in Symptomatic Irreversible Pulpitis |
| title_full | Sensitivity, Specificity, Predictive Values, and Accuracy of Three Diagnostic Tests to Predict Inferior Alveolar Nerve Blockade Failure in Symptomatic Irreversible Pulpitis |
| title_fullStr | Sensitivity, Specificity, Predictive Values, and Accuracy of Three Diagnostic Tests to Predict Inferior Alveolar Nerve Blockade Failure in Symptomatic Irreversible Pulpitis |
| title_full_unstemmed | Sensitivity, Specificity, Predictive Values, and Accuracy of Three Diagnostic Tests to Predict Inferior Alveolar Nerve Blockade Failure in Symptomatic Irreversible Pulpitis |
| title_short | Sensitivity, Specificity, Predictive Values, and Accuracy of Three Diagnostic Tests to Predict Inferior Alveolar Nerve Blockade Failure in Symptomatic Irreversible Pulpitis |
| title_sort | sensitivity specificity predictive values and accuracy of three diagnostic tests to predict inferior alveolar nerve blockade failure in symptomatic irreversible pulpitis |
| url | http://dx.doi.org/10.1155/2017/3108940 |
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