Is the degree of facial swelling after dental extraction sufficient to justify the current delays to radiotherapy mask production? A pilot evaluation of postextraction swelling using 3D photography.

Background: Concern that facial swelling after dental extractions will spoil the fit of radiotherapy masks in head and neck cancer patients leads to the current practice of delay making of mask production (and therefore the start of radiotherapy) for several days or longer. However, there is little data on how extensive facial swelling is after dental extraction.

Aim: To assess the degree of facial swelling in a group of adult patients attending Newcastle Dental School for routine dental extractions.

Injectable local anaesthetic agents for dental anaesthesia.

Background: Pain during dental treatment, which is a common fear of patients, can be controlled successfully by local anaesthetic. Several different local anaesthetic formulations and techniques are available to dentists.

Objectives: Our primary objectives were to compare the success of anaesthesia, the speed of onset and duration of anaesthesia, and systemic and local adverse effects amongst different local anaesthetic formulations for dental anaesthesia.

Determination of the mental foramen position in dental radiographs in 18-30 year olds.

Objectives: To determine the radiographic position and reliability of assessing mental foramen (MF) position in relation to premolar crowns in an 18- to 30-year-old UK-based population.

Methods: Following ethical approval and a power calculation, the position of the MF was recorded in relation to premolar crowns and apices in 100 dental panoramic tomographs. Positions were assessed by three senior clinicians independently, then by consensus.

Use of Pre-Injection Diffusion of Local Anaesthetic as a Means of Reducing Needle Penetration Discomfort.

Aim: To determine if pre-injection diffusion of local anaesthetic solution influences the discomfort of needle penetration in the palate.

Methods: A placebo-controlled, randomised, double-blind split-mouth investigation was conducted. 25 healthy adult volunteers were recruited and each received two needle penetrations in a random order during one visit.

Haemostasis. Part 2: Medications that affect haemostasis.

Post-operative haemorrhage is a recognized complication in dental practice. This may be more prevalent in patients taking antithrombotic medications. It is important that the dentist understands the mechanism of action of these drugs and how they may affect management of dental patients.

Haemostasis. Part 1: The management of post-extraction haemorrhage.

Unlabelled: The management of bleeding complications following a dental extraction is an essential skill for the dental practitioner. Extractions are often carried out on patients with complex medical histories and a long list of medications. This paper aims to help the clinician manage post-extraction haemorrhage.

Is mandibular molar buccal infiltration a mental and incisive nerve block? A randomized controlled trial.

Introduction: The aim of this study was to compare the efficacies of buccal local anesthetic infiltrations at various sites of the mandible in order to elucidate the mechanism of action of articaine mandibular infiltrations.

Methods: After a power calculation and ethical approval, 22 volunteers received 1.8 mL 4% articaine hydrochloride with 1:100,000 adrenaline as a buccal infiltration at the canine, first, or second molar in a randomized, double-blind, crossover design.

Articaine (4%) with epinephrine (1:100,000 or 1:200,000) in intraosseous injections in symptomatic irreversible pulpitis of mandibular molars: anesthetic efficacy and cardiovascular effects.

Objective: The aim of this study was to compare the cardiovascular effects and the anesthetic efficacy of intraosseous injections of 4% articaine with 1:100,000 epinephrine (EPI100) or 4% articaine with 1:200,000 epinephrine (EPI200).

Study Design: In this prospective, randomized, double-blind study, 0.9 mL EPI100 and EPI200 solutions were administered for endodontic treatment of mandibular molars with symptomatic irreversible pulpitis in 60 patients.

A prospective randomized trial of different supplementary local anesthetic techniques after failure of inferior alveolar nerve block in patients with irreversible pulpitis in mandibular teeth.

Objective: The objective of this study was to compare the efficacy of supplementary repeat inferior alveolar nerve block with 2% lidocaine and epinephrine, buccal infiltration with 4% articaine with epinephrine, intraligamentary injection, or intraosseous injection (both with 2% lidocaine with epinephrine) after failed inferior alveolar nerve block (IANB) for securing pain-free treatment in patients experiencing irreversible pulpitis in mandibular permanent teeth.

Methods: This randomized clinical trial included 182 patients diagnosed with irreversible pulpitis in mandibular teeth. Patients received 2.

A comparison of the efficacy of 4% articaine with 1:100,000 epinephrine and 2% lidocaine with 1:80,000 epinephrine in achieving pulpal anesthesia in maxillary teeth with irreversible pulpitis.

Introduction: To assess the efficacy of buccal infiltrations of 4% articaine with 1:100,000 epinephrine and 2% lidocaine with 1:80,000 epinephrine in achieving anesthesia in maxillary teeth with irreversible pulpitis.

Methods: This randomized double-blind clinical trial included 100 patients diagnosed with irreversible pulpitis in maxillary teeth. Patients received 2.

The use of the mandibular infiltration anesthetic technique in adults.

Background: The author describes the use of the infiltration anesthetic technique to anesthetize mandibular teeth in adults and explores its mechanism of action.

Methods: The author reviewed articles describing randomized controlled trials of the mandibular infiltration anesthetic technique in healthy participants.

Results: The author found that using the mandibular infiltration anesthetic technique can produce anesthesia in adult mandibular teeth.

Articaine and lignocaine.

Data Sources: Cochrane Central, Medline, Embase, and ProQuest Health and Medical Complete, the metaRegister of the controlled trials database and a leading manufacturer.

Study Selection: Randomised controlled trials in patients requiring non-complex routine dental treatments comparing 4% articaine (1:100,000 epinephrine) with 2% lignocaine (1:100,000 epinephrine) for maxillary and mandibular infiltrations and block anaesthesia were included. The principal outcome measures were anaesthetic success, onset of action, post-injection adverse events or post-injection pain.

The Oral Health Impact Profile: ranking of items for temporomandibular disorders.

The study aimed to rank the Oral Health Impact Profile (OHIP-49) items by relevance to temporomandibular disorders (TMD). A modified version of the OHIP-49 was completed by 110 patients with TMD and by age- and gender-matched TMD-free individuals. Patients were diagnosed using the Research Diagnostic Criteria (RDC) for TMD.

Pharmacology and the elderly.

Unlabelled: This paper describes the impact of ageing on an individual's ability to process drugs. It considers adverse drug reactions in the elderly and discusses prescribing for the older dental patient.

Clinical Relevance: Many older dental patients will be suffering from medical conditions or taking prescribed or non-prescribed drugs.

A comparison of the anterior middle superior alveolar nerve block and infraorbital nerve block for anesthesia of maxillary anterior teeth.

Background: The authors conducted a study to compare the efficacy of the anterior middle superior alveolar (AMSA) nerve block with that of the infra-orbital nerve block (IONB) in achieving pulpal anesthesia in the anterior maxilla.

Methods: Twenty-eight healthy adult volunteers received 1.0 milliliter of 2 percent lidocaine with 1:80,000 epinephrine as an AMSA nerve block or IONB via computer-controlled local anesthetic delivery (CCLAD) across two visits.

Infiltration anesthesia in the mandible.

Infiltration is preferred to regional block techniques in the maxilla as the former offers a number of advantages. This paper considers the evidence for the efficacy of infiltration anesthesia in the mandible in the adult dentition, both as a primary and as a supplemental method.

Effect of time on clinical efficacy of topical anesthesia.

The objective of this study was to determine the effect of time on the clinical efficacy of topical anesthetic in reducing pain from needle insertion alone as well as injection of anesthetic. This was a randomized, double-blind, placebo-controlled, split-mouth, clinical trial which enrolled 90 subjects, equally divided into 3 groups based upon time (2, 5, or 10 minutes) of topical anesthetic (5% lidocaine) application. Each group was further subdivided into 2: needle insertion only in the palate or needle insertion with deposition of anesthetic (0.

Local anaesthesia: risks and controversies.

Unlabelled: This paper describes the complications that can occur as the result of the intra-oral injection of local anaesthetics. It considers important localized and systemic complications and describes strategies to limit the occurrence of such problems.

Clinical Relevance: Local anaesthetics are routinely administered during many dental procedures.

Anesthetic efficacy of 3 volumes of lidocaine with epinephrine in maxillary infiltration anesthesia.

The objective of this randomized double-blind investigation was to compare the anesthetic efficacy and injection discomfort of 3 volumes of 2% lidocaine with 1:100,000 epinephrine for maxillary infiltration anesthesia. A total of 25 subjects received 0.6, 0.

Articaine infiltration for anesthesia of mandibular first molars.

A randomized, controlled trial of 31 healthy volunteers compared 4% articaine with 1:100,000 epinephrine buccal infiltration to buccal plus lingual infiltration of the same dose of drug in achieving pulpal anesthesia of mandibular first molar teeth. Data were compared with efficacy of an inferior alveolar nerve block using 2% lidocaine 1:80,000 epinephrine in a cohort of 27 of the volunteers. Anesthesia was determined using electronic pulp testing.

The management of hypodontia: present and future.

Unlabelled: Developmental absence of teeth (hypodontia) is associated with characteristic morphological changes in the teeth, alveolar volume deficiencies, and skeletal jaw mal-relationships. Management may be complex, involving several dental specialties, ideally working as a close-knit team. Improved diagnostic and treatment technologies continue to evolve, ever widening the management opportunities for these patients.

A method for clinically defining "improvers" in chronic pain studies.

Aims: To test a measurement model based on clinicians' assessments of patient data that allows simple and confident clinical validation of any statistical or numerical technique designed to separate patients improving with treatment from those who are not, particularly for pain that shows large daily variation.

Methods: Diaries using daily visual analog scales (VAS) of pain intensity were obtained from 39 patients treated for chronic temporomandibular disorders. Three experienced clinicians visually assessed 39 VAS/time graphs.

Influence of injection speed on the effectiveness of incisive/mental nerve block: a randomized, controlled, double-blind study in adult volunteers.

This randomized, double-blind trial tested the null hypothesis that speed of deposition has no influence on the injection discomfort, efficacy, distribution, and duration of pulp anesthesia after incisive/mental nerve block in adult volunteers. Thirty-eight subjects received incisive/mental nerve blocks of 2.0 mL lidocaine with 1:80,000 epinephrine slowly over 60 seconds or rapidly over 15 seconds at least 1 week apart.

The effects of antihypertensive medication on dental treatment.

Unlabelled: Hypertension is a medical problem that impacts on health worldwide. A number of different medications are used to treat hypertension. These drugs can affect the mouth and perioral structures and impact upon dental management.