- Local Anesthesia Part 9: The Future of Pain Cont...
- Local Anesthesia Part 8: Articaine - Is it the I...
- Local Anesthesia Parts 6 & 7: Local and Systemic...
- Periodontal health during orthodontic treatment ...
- Smile prevails over other facial components of m...
- Controlling caries in exposed root surfaces with...
- Local Anesthesia Part 4 & 5: Mandibular & Supple...
Local Anesthesia Part 9: The Future of Pain Control in Dentistry
Though local anesthetics are safe and effective, considerable research is on-going to make them even more effective. Computer-controlled local anesthetic delivery systems (C-CLAD) and buffered local anesthetic solutions promise to allow painless injections to be delivered to dental patients almost anywhere in the oral cavity. Fear of injections is primarily based on the needle. The development of an intranasal local anesthetic mist has been shown to provide successful pulpal anesthesia of maxillary teeth – without a needle. Epinephrine is added to injectable local anesthetics to increase their effectiveness, duration and safety. However the duration of residual soft tissue anesthesia – usually unnecessary and occasionally a potential danger – is extended when epinephrine is used in the anesthetic solution. Self-inflicted soft tissue injury is a real problem associated with this anesthesia in all patient age groups but especially pediatric and geriatric patients. Phentolamine mesylate – an alpha adrenergic antagonist – has been shown to significantly reduce the duration of residual soft tissue anesthesia when administered at the conclusion of the traumatic part of dental treatment.
Local Anesthesia Part 8: Articaine - Is it the IDEAL local anesthetic for dentistry? Facts & Fiction
Articaine HCl was introduced in the USA in 2000 and has become a very popular anesthetic agent. Though classified as an amide local anesthetic it is actually a hybrid molecule, possessing both ester and amide characteristics. With epinephrine, articaine provides approximately 60 minutes of pulpal anesthesia and between 3 to 5 hours of soft tissue anesthesia. Its unique molecular characteristics make articaine a preferred anesthetic in the pregnant and the nursing patient as well as the lighter weight (<30kg) pediatric patient. However, articaine is used as a 4% solution and there has been some concern about the possibility of 4% anesthetics possessing a greater risk of producing paresthesia than local anesthetics used in lesser concentrations.
This program provides an in-depth look at articaine, its advantages and disadvantages when compared with other commonly used dental local anesthetics. We also discuss the ‘controversy’ alleging an increased risk of paresthesia following administration of 4% local anesthetics.
Local Anesthesia Parts 6 & 7: Local and Systemic Complications
Complications associated with local anesthetic administration are rare. This program discusses complications occurring in and around the site of local anesthetic drug administration - facial nerve paralysis, hematoma, paresthesia, trismus and needle breakage, their prevention, recognition and management as well as the two systemic adverse drug reactions – allergy and overdose – are reviewed as each relates to the administration of local anesthetic drugs.
Periodontal health during orthodontic treatment with clear aligners and fixed appliances
Clear aligners have become increasingly popular because of their esthetics and comfort. The authors’ aim in this systematic review was to compare periodontal health in patients undergoing orthodontic treatment with clear aligners with that of those undergoing orthodontic treatment with fixed appliances. The authors systematically searched the PubMed, Web of Science, Cochrane Library, and Embase databases to collect related studies. After extracting data and assessing quality, the authors performed a meta-analysis and trial sequential analysis. The authors used the Grading of Recommendations Assessment, Development and Evaluation system to assess the quality of the evidence.
Key Words. Gingivitis; orthodontic appliances; literature review.
Smile prevails over other facial components of male facial esthetics
The aim of this study was to assess whether scores assigned to the eyes, nose, mouth, and chin regions work as predictors of full smiling face scores. In this cross-sectional study, the authors used the facial photographs of 86 smiling men. Photographs yielded 5 components: 1 of the face itself and 4 subcomponents (eyes, nose, mouth, and chin region). Raters assigned the photographs beauty scores that the authors measured morphometrically. The authors analyzed the predictive ability of the subcomponents against that of the full face.
Key Words. Face; facial esthetics; facial beauty; beauty; smile esthetics; smiles; predictors.
Controlling caries in exposed root surfaces with silver diamine fluoride
In this systematic review, the authors aim to assess the effect of silver diamine fluoride (SDF) in preventing and arresting caries in exposed root surfaces of adults. Two reviewers independently searched for controlled clinical trials with at least 12 months of follow-up, without language or date of publication restraints, in 8 electronic databases, 5 registries of ongoing trials, and reference lists of narrative reviews.
Key Words. Root caries; preventive dentistry; cariostatic agents; fluoride; dental health care for aged; systematic review.
Local Anesthesia Part 4 & 5: Mandibular & Supplemental Techniques
Techniques of anesthesia in the mandible are reviewed in this program, including the traditional inferior alveolar, Gow-Gates, Vazirani-Akinosi, and incisive nerve blocks as well as several non-traditional injection techniques including the periodontal ligament injection, intraosseous anesthesia and the administration of the local anesthetic articaine HCl by mandibular infiltration in adult patients.
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