Effect of Ketones on the Onset of Local Anesthesia among Diabetic Patients in the Kingdom of Saudi Arabia
Abdulaziz S AbuMelha, Amal S Alshahrani, Noura A AbuMelha
Blood glucose, Diabetes, Ketones, Local anesthesia
Citation Information :
AbuMelha AS, Alshahrani AS, AbuMelha NA. Effect of Ketones on the Onset of Local Anesthesia among Diabetic Patients in the Kingdom of Saudi Arabia. World J Dent 2018; 9 (4):280-283.
Aim: To evaluate the effect of blood ketones on the onset of local anesthetic (LA) effect among diabetic patients in Abha, Kingdom of Saudi Arabia.
Materials and methods: A convenient sample of 34 subjects was taken for the study. All those who were suffering from diabetes mellitus (types I or II), aged 40 to 70 years, having vital maxillary anterior teeth and who were willing to participate, were enrolled for the study. Moreover, 15 nondiabetic (healthy) patients who had visited the Department of Restorative Dental Sciences for undergoing endodontic treatment of maxillary anterior teeth were also included in the study. The subjects were checked for blood glucose level and blood ketone values. All the participants were given infiltration in maxillary central incisor teeth using 2% lidocaine with epinephrine for all the participants. The onset of the effect of LA was checked using thermal test (cold Endo Ice) and Electron Pulp tester (EPT).
Results: The average blood ketone value among the controlled type I and controlled and uncontrolled type II was found to be 0.1 mmol/L, while it was 0.2 mmol/L among the subjects with uncontrolled type I diabetes.
Conclusion: The onset of LA effect was found to be within 3 minutes in all cases except those with type I uncontrolled diabetes wherein it was found to be 4 minutes. The difference was not found to be statistically significant.
Clinical significance: Due to long-term hyperglycemic condition in diabetic patients, their body cells are unable to get energy from carbohydrates due to lack of insulin and it thus results in the utilization of the body fats as source of energy, producing ketones as by-product. Hence, knowing the effect of ketones, if any, on the onset of LA would be quite beneficial.
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