{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,12]],"date-time":"2026-06-12T05:59:33Z","timestamp":1781243973196,"version":"3.54.1"},"reference-count":13,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,6,12]],"date-time":"2026-06-12T00:00:00Z","timestamp":1781222400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Oral Health"],"abstract":"\n Objectives<\/jats:title>\n Needle tip deformation is a recognized occurrence during dental local anesthesia that may affect injection safety and efficacy. This study aimed to assess the prevalence, extent, and direction of needle tip deformation and its association with operator level, bone contact sensation, and injection approach in maxillary infiltration.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n This cross-sectional study analyzed 180 dental needle samples, including 90 experimental and 90 control samples. The experimental group was subdivided into three injection approaches: buccal infiltration only, palatal infiltration only, and sequential buccal-then-palatal infiltration performed using the same needle. Needle tip deformation was examined using a field-emission scanning electron microscope (FE-SEM), and the extent of deformation was quantified with ImageJ software. Statistical analyses compared the prevalence, extent, and direction of deformation across practitioner levels and injection approaches.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n Needle tip deformation occurred more frequently in the experimental group (55.6%) compared with controls (1.1%) (\n \u03c7<\/jats:italic>\n 2<\/jats:sup>\n \u2009=\u200965.691,\n p<\/jats:italic>\n \u2009&lt;\u2009.001). No significant differences in the prevalence of deformation were observed across injection approaches (\n \u03c7<\/jats:italic>\n 2<\/jats:sup>\n \u2009=\u20092.520,\n p<\/jats:italic>\n \u2009=\u2009.284). Fourth-year dental students and interns demonstrated comparable rates of deformation (53.3% vs. 57.8%) (\n \u03c7<\/jats:italic>\n 2<\/jats:sup>\n \u2009=\u20090.180,\n p<\/jats:italic>\n \u2009=\u2009.671) and non-different extent of deformation (t\u2009=\u20090.588,\n p<\/jats:italic>\n \u2009=\u2009.588). The direction of deformation (inward 52.2% vs. outward 47.8%) showed no significant association with operator level (\n \u03c7<\/jats:italic>\n 2<\/jats:sup>\n \u2009=\u20096.523,\n p<\/jats:italic>\n \u2009=\u2009.163) and no significant difference in the extent of deformation (t\u2009=\u2009\u22121.275,\n p<\/jats:italic>\n \u2009=\u2009.209). Although the sensation of bone contact varied significantly by injection type (\n \u03c7<\/jats:italic>\n 2<\/jats:sup>\n \u2009=\u200913.289,\n p<\/jats:italic>\n \u2009=\u2009.004), it was not associated with actual needle tip deformation (\n \u03c1<\/jats:italic>\n \u2009=\u20090.140,\n p<\/jats:italic>\n \u2009=\u20090.189).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n Needle tip deformation occurred in more than half of maxillary infiltration procedures. The prevalence and extent of deformation were not influenced by operator level, bone contact, or the infiltration approach in buccal, palatal, and sequential buccal-palatal injections. Future studies should assess patient-centered and anesthetic outcomes to determine its clinical relevance.<\/jats:p>\n <\/jats:sec>","DOI":"10.3389\/froh.2026.1774756","type":"journal-article","created":{"date-parts":[[2026,6,12]],"date-time":"2026-06-12T05:45:00Z","timestamp":1781243100000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Prevalence and patterns of dental needle tip deformation during maxillary buccal and palatal infiltration anesthesia"],"prefix":"10.3389","volume":"7","author":[{"given":"Mohammed Amjed","family":"Alsaegh","sequence":"first","affiliation":[{"name":"Department of Oral and Craniofacial Health Sciences, College of Dental Medicine, University of Sharjah .","place":["Sharjah, United Arab Emirates"]},{"name":"Research Institute for Medical and Health Sciences, University of Sharjah","place":["Sharjah, United Arab Emirates"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Taibah Abdullah","family":"Alkandari","sequence":"additional","affiliation":[{"name":"University Dental Hospital Sharjah, University of Sharjah","place":["Sharjah, United Arab Emirates"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mariam Mohammad","family":"Jumah","sequence":"additional","affiliation":[{"name":"University Dental Hospital Sharjah, University of Sharjah","place":["Sharjah, United Arab Emirates"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zahraa Bader","family":"Khasroh","sequence":"additional","affiliation":[{"name":"University Dental Hospital Sharjah, University of Sharjah","place":["Sharjah, United Arab Emirates"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Farah Ahmad","family":"Alenezi","sequence":"additional","affiliation":[{"name":"University Dental Hospital Sharjah, University of Sharjah","place":["Sharjah, United Arab Emirates"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,6,12]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"127","DOI":"10.2344\/0003-3006-59.3.127","article-title":"Local anesthesia part 2: technical considerations","volume":"59","author":"Reed","year":"2012","journal-title":"Anesth Prog"},{"key":"B2","volume-title":"Handbook of Local Anesthesia","author":"Malamed","year":"2020"},{"key":"B3","first-page":"E317","article-title":"Comparison of two needle models in terms of bevel deformation during truncal block of the inferior alveolar nerve","volume":"12","author":"Almendros Marqu\u00e9s","year":"2007","journal-title":"Med Oral Patol Oral Cir Bucal"},{"key":"B4","first-page":"48","article-title":"Needle tip deformation after PDL and intraseptal dental local anesthesia","volume":"2","author":"Kuzin","year":"2014","journal-title":"J Head Neck Physicians Surg"},{"key":"B5","doi-asserted-by":"publisher","first-page":"105034","DOI":"10.1016\/j.jmbbm.2021.105034","article-title":"Needle tip deformation in local dental anesthesia: a technical note","volume":"126","author":"Hartmann","year":"2022","journal-title":"J Mech Behav Biomed Mater"},{"key":"B6","doi-asserted-by":"publisher","first-page":"325","DOI":"10.1111\/aej.12361","article-title":"Evaluation of bevelled needle tip deformation with dental inferior alveolar nerve blocks","volume":"45","author":"Skapetis","year":"2019","journal-title":"Aust Endod J"},{"key":"B7","doi-asserted-by":"publisher","first-page":"1484","DOI":"10.1016\/j.ijom.2017.06.013","article-title":"Influence of needle bevel design on injection pain and needle deformation in dental local infiltration anaesthesia - randomized clinical trial","volume":"46","author":"Dau","year":"2017","journal-title":"Int J Oral Maxillofac Surg"},{"key":"B8","doi-asserted-by":"publisher","first-page":"308","DOI":"10.1186\/s12909-018-1389-6","article-title":"Local anaesthesia training for undergraduate students - how big is the step from model to man?","volume":"18","author":"Knipfer","year":"2018","journal-title":"BMC Med Educ"},{"key":"B9","doi-asserted-by":"publisher","first-page":"2315","DOI":"10.1016\/j.jds.2024.02.008","article-title":"Dental students, interns, and junior dentists\u2019 awareness and attitude toward the inferior alveolar nerve block technique and related failure","volume":"19","author":"Sakka","year":"2024","journal-title":"J Dent Sci"},{"key":"B10","doi-asserted-by":"publisher","first-page":"585","DOI":"10.1016\/0030-4220(94)90315-8","article-title":"Barbed needle and inexplicable paresthesias and trismus after dental regional anesthesia","volume":"77","author":"Stacy","year":"1994","journal-title":"Oral Surg Oral Med Oral Pathol"},{"key":"B11","doi-asserted-by":"publisher","first-page":"170","DOI":"10.1007\/s00784-024-05546-0","article-title":"The bevel effect: a prospective, randomized investigation into needle design in dental intraligamentary anesthesia","volume":"28","author":"K\u00e4mmerer","year":"2024","journal-title":"Clin Oral Investig"},{"key":"B12","doi-asserted-by":"publisher","first-page":"755","DOI":"10.1002\/jdd.13198","article-title":"A comparison of simulation and traditional local anesthesia teaching methods among dental hygiene students","volume":"87","author":"Thelen","year":"2023","journal-title":"J Dent Educ"},{"key":"B13","doi-asserted-by":"publisher","first-page":"370","DOI":"10.12968\/denu.2003.30.7.370","article-title":"An investigation of the effect on 27-gauge needle tips following a single local anaesthetic injection","volume":"30","author":"Rout","year":"2003","journal-title":"Dent Update"}],"container-title":["Frontiers in Oral Health"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/froh.2026.1774756\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,12]],"date-time":"2026-06-12T05:45:01Z","timestamp":1781243101000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/froh.2026.1774756\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,6,12]]},"references-count":13,"alternative-id":["10.3389\/froh.2026.1774756"],"URL":"https:\/\/doi.org\/10.3389\/froh.2026.1774756","relation":{},"ISSN":["2673-4842"],"issn-type":[{"value":"2673-4842","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,6,12]]},"article-number":"1774756"}}