Journal of Dental Medicine

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Different techniques for local anesthesia are used in the mandible. The purpose of this study was to determine the effects of inferior alveolar dental nerve blocks by comparing the two akinosi and conventional techniques. 80 patients (aged 15-60 years old) were randomly divided into tow groups for extracting the mandibuler posterior teeth by akinosi and conventional techniques. Patients were all injected with 1.8 ml of Lidocaine 2% plus Adernaline j^nnnn .Then the Pain Sensation during injection,positive aspiration, beginning time of anesthesia, duration of anesthesia depth of anesthesia, and the anesthesia of soft tissue related to sensory nerves were evaluated. The results showed that the pain sensation in conventional technique was significantly higher than that of akinosi technique. The number of positive aspirations in conventional technique (12,5%) was higher than that of akinosi (5%) but not significantly different. The long buccal nerve anesthesia in akinosi technique (75%) was significantly higher than that of conventional technique. There was no significant difference between the two techniques for the depth of anesthesia. The success rate was 87.5% in conventional technique and 80% in akinosi technique. The average time of lips anesthesia in conventional technique was 3 minutes compared with 4 minutes in akinosi technique, which was not significantly different from each other. However, the beginning time of aneshtesia in tongue was significantly lower in conventional technique. No significant difference in the duration of anesthesia in lips and tonques between the two techniques was observed.

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Background and Aim: Along with higher usage of dental local anesthesia with risks to people health together with their positive role, the important goal of dentistry, patients’ health, has been stressed repeatedly nowadays. This study was conducted to compare O2 saturation, respiratory rate and heart rate of patients following injection of anesthetic containing vasoconstrictor (lidocaine 2%) and without vasoconstrictor (Mepivacaine).

Materials and Methods: This experimental study was conducted on 32 healthy humans (16 females and 16 males) with 25-50 years age range and no history of drug usage. Cases were classified into two matched groups. O2 saturation, heart and respiratory rate were recorded before extraction of a mandibular posterior tooth. In the first group, 3.6 ml lidocaine 2% with 1:80,000 epinephrine and in the second group Mepivacaine 3% was injected, using inferior alveolar dental nerve block with aspiration. Variables were measured and recorded. Tooth extraction was performed and the mentioned variables were recorded again. Data were analyzed with SPSS software using t and Paired t-test with P<0.05 as the limit of significance.

Results: After injection of lidocaine, the heart rate was increased (12.25±1.75 bpm), and the time to reach the maximum rate was 64.75±11.26 seconds. After extraction of tooth, heart rate in both groups was increased not considering the type of injection.

Conclusion: The study showed that the injection of lidocaine (containing epinephrine) in patients without contraindication has no risk. Also, possible increase in heart rate is not risky and is not associated with O2 saturation decrease and respiratory interruption.

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Background and Aim: Several factories produce dental cartridge in the world. In Iran, Daroupakhsh company is responsible for this task. The aim of this study was evaluate some properties of daroupakhsh cartridge and compare them with two imported ones: Ecocaine (made in Italy) and Septodont (made in France).

Materials and Methods: In this experimental study, 70 healthy patients from maxillofacial clinic of Shariaty hospital were selected. After obtaining informed consent, 0.1 cc of each carpule was injected to the patients' frontal region and the extent of anesthesia was measured at different time intervals. Also the quality of injections was evaluated by 11 surgeons. The dimensions of the three cartridges were also measured and compared together. Data were analyzed by repeated measure ANOVA and Friedman with p<0.05 as the limit of significance. Results: There was no significant difference in extent and duration of anesthesia among the studied cartridges. Surgeons were equally satisfied of all three kinds of cartridges. All of the cartridges were aspirable.

Conclusion: Based on the results of this study, the three studied cartridges had similar properties.

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Background and Aim: Inducing anesthesia is one of the important tasks in dentistry. Among various techniques for injection, the Inferior Alveolar Nerve Block (IANB) technique is one of the most practical and prevalent methods. However, according to some proofs in reference books, the success rate for this technique is some how low. Therefore the success rate of IANB performed by 10th-semester undergraduare students from Faculty of Dentistry of Tehran University of Medical Sciences was assessed in this study.

Materials and Methods: In this cross-sectional study from patients referring to oral and maxillofacial surgery ward, 20 patients with predefined conditions were selected. For each of them, two IANB injections were done in two separated days one by a student and the other by an attend (or resident) of maxillofacial surgery ward. Success or failure of each injection was examined by Pin Prick test. In this study, the non-parametric Willcoxon test was used.

Results: In this study, the success rate of IANB was 70% and 90%, respectively for students and attends (or resident).

Conclusion: Significant statistically difference was seen between the two groups, we hope that through further practical education, this differences rsduce in following similar studies.

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Background and Aim: According to controversies in the prevalence of hypersensitivity to dental local anesthetic drugs and patients who claim hypersensitivity to these drugs, the aim of this study was to determine the prevalence of hypersensitivity to dental amide local anesthetic drugs in patients referred to Tehran Allergy Clinic in 2005-2007.

Materials and Methods: In this Study (Review of existing data), records of 130 patients who were referred to "Tehran allergy Clinic" (2005-2007) were studied.

Results: The average age of patients was 29.5±18.8 years. 34% of cases showed positive skin reactions to at least one of the tested Lidocain concentrations and 10% of cases showed positive skin reactions to at least one of the tested Prilocain concentrations. There was a statistically significant difference in hypersensitivity to Lidocain 0.01 and 0.001 (p=0.017) and also between Lidocain 0.001 and 0.0001 (p<0.01). There was no statistically significant difference between other tested drug concentrations (p>0.05).

Conclusion: Many patients with history of hypersensitivity, show positive reaction to local dental anesthetic drugs. Prilocain hypersensitivity reactions are less than Lidocain. So application of Prilocain accompanies with less risk but its application should not be considered completely safe.

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  Background and Aims: Successful pediatric dentistry depends on the dentist's technical skills, as well as his/her ability to acquire and maintain a child's cooperation. The correction of dentist’ performance in this area affects the view of parents and increases the quality of dental services. The aim of this study was to evaluate the attitudes of general dentists toward behavior guidance techniques in Isfahan.

  Materials and Methods: In this descriptive- analytic cross-sectional study, 100 general dentists of Isfahan city were selected with simple random sampling technique. They were asked to complete the questionnaire inquiring their attitude toward four different behavioral management techniques . An appropriate question about each of the methods was proposed by the authors, along with demographic characteristics including: gender, age, university, year of graduation, work experience, the mean number of pediatric patients referred in one month was provided in the form of a questionnaire. To evaluate the attitude of dentists to the questionnaire, the score from 1 to 5 was given to each item and the total score was considered. Higher score indicated more positive attitude of dentist. Data were analyzed using T-test, Pearsons correlation and one-way ANOVA (P<0.05).

  Results: The mean scores for dental behavioral management techniques were positive reinforcement (4.2±2.7), general anesthesia (3.5±4.4), N₂O sedation (3.4±4.4) and pharmacologic sedation (3.2±2.7), respectively. There were no significant differences between the mean score of dentist attitude and age, gender, clinical experience and the number of pediatric patient (P>0.05).

  Conclusion: General dentists’ attitudes towards different behavior management techniques were associated with age, gender, clinical experience and the number of pediatric patient. General dentists’ tend was more towards non-drug behavior control methods such as positive reinforcement.

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  Background and Aims: Postoperativee endodontic pain is an outstanding problem for dental patients. Therefore, a successful management of endodontic pain has become as one of the main dental objectives. The aim of the present study was to compare the postoperative endodontic pain in patients under general anesthesia versus local anesthesia.

  Materials and Methods: For conducting this clinical trial study, 50 patients having mandibular molars candidate for root canal therapy were selected. Twenty-five patients treated under general anesthesia because of their fear, anxiety or gag reflex. Other 25 patients treated under local anesthesia. All teeth were prepared using engine-driven rotary system in a crown-down technique and filled using lateral condensation technique. Heft- parker visual analog scale was used to measure the degree of pain at 6, 12, 24, and 48 hours after the treatment. Mann-Whitney, Chi-square, and T-tests were used to compare the intensity of postoperative pain between the groups.

  Results: The mean intensity of postoperative pain in local and general anesthesia groups at 6, 12 and 24 hours had statistically significant difference (P<0.05).

  Conclusion: Postoperative pain in patients who treated under general anesthesia was significantly less than the patients who treated under local anesthesia.

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