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Efficacy and safety of 2% lidocaine HCl with 1:200,000 epinephrine (1:200,000 에피네프린 리도카인의 소개)

  • Karm, Myong-Hwan
    • The Journal of the Korean dental association
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    • v.56 no.1
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    • pp.42-48
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    • 2018
  • INTRODUCTION The most commonly impacted tooth is the third molar. An impacted third molar can ultimately cause acute pain, infection, tumors, cysts, caries, periodontal disease, and loss of adjacent teeth. Local anesthesia is employed for removing the third molar. This study aimed to evaluate the efficacy and safety of 2% lidocaine with 1:80,000 or 1:200,000 epinephrine for surgical extraction of bilateral impacted mandibular third molars. METHODS Sixty-five healthy participants underwent surgical extraction of bilateral impacted mandibular third molars in two separate visits while under local anesthesia with 2% lidocaine with different epinephrine concentration (1:80,000 or 1:200,000) in a double-blind, randomized, crossover trial. Visual analogue scale pain scores obtained immediately after surgical extraction were primarily evaluated for the two groups receiving different epinephrine concentrations. Visual analogue scale pain scores obtained 2, 4, and 6 h after administering an anesthetic, onset and duration of analgesia, onset of pain, intraoperative bleeding, operator's and participant's overall satisfaction, drug dosage, and hemodynamic parameters were evaluated for the two groups. RESULTS There were no statistically significant differences between the two groups in any measurements except hemodynamic factors (P > .05). Changes in systolic blood pressure and heart rate following anesthetic administration were significantly greater in the group receiving 1:80,000 epinephrine than in that receiving 1:200,000 epinephrine ($P{\leq}01$). CONCLUSION The difference in epinephrine concentration between 1:80,000 and 1:200,000 in 2% lidocaine liquid does not affect the medical efficacy of the anesthetic. Furthermore, 2% lidocaine with 1:200,000 epinephrine has better safety with regard to hemodynamic parameters than 2% lidocaine with 1:80,000 epinephrine. Therefore, we suggest using 2% lidocaine with 1:200,000 epinephrine rather than 2% lidocaine with 1:80,000 epinephrine for surgical extraction of impacted mandibular third molars in hemodynamically unstable patients.

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Effect of different denture cleansers on surface roughness and microhardness of artificial denture teeth

  • Yuzugullu, Bulem;Acar, Ozlem;Cetinsahin, Cem;Celik, Cigdem
    • The Journal of Advanced Prosthodontics
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    • v.8 no.5
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    • pp.333-338
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    • 2016
  • PURPOSE. The aim of this study was to compare the effects of different denture cleansers on the surface roughness and microhardness of various types of posterior denture teeth. MATERIALS AND METHODS. 168 artificial tooth specimens were divided into the following four subgroups (n=42): SR Orthotyp PE (polymethylmethacrylate); SR Orthosit PE (Isosit); SR Postaris DCL (double cross-linked); and SR Phonares II (nanohybrid composite). The specimens were further divided according to the type of the denture cleanser (Corega Tabs (sodium perborate), sodium hypochlorite (NaOCl), and distilled water (control) (n=14)) and immersed in the cleanser to simulate a 180-day immersion period, after which the surface roughness and microhardness were tested. The data were analyzed using the Kruskal-Wallis test, Conover's nonparametric multiple comparison test, and Spearman's rank correlation analysis (P<.05). RESULTS. A comparison among the denture cleanser groups showed that NaOCl caused significantly higher roughness values on SR Orthotyp PE specimens when compared with the other artificial teeth (P<.001). Furthermore, Corega Tabs resulted in higher microhardness values in SR Orthotyp PE specimens than distilled water and NaOCl (P<.005). The microhardness values decreased significantly from distilled water, NaOCl, to Corega Tabs for SR Orthosit PE specimens (P<.001). SR Postaris DLC specimens showed increased microhardness when immersed in distilled water or NaOCl when compared with immersion in Corega Tabs (P<.003). No correlation was found between surface roughness and microhardness (r=0.104, P=.178). CONCLUSION. NaOCl and Corega Tabs affected the surface roughness and microhardness of all artificial denture teeth except for the new generation nanohybrid composite teeth.

Decreased post-operative pain using a sublingual injection of dexamethasone (8 mg) in lower third molar surgery

  • Gozali, Peiter;Boonsiriseth, Kiatanant;Kiattavornchareon, Sirichai;Khanijou, Manop;Wongsirichat, Natthamet
    • Journal of Dental Anesthesia and Pain Medicine
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    • v.17 no.1
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    • pp.47-53
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    • 2017
  • Background: Every patient who undergoes mandibular third molar surgery is concerned about post-operative pain. Indeed, previous researchers have used various methods to treat such pain. This study aimed to assess the effectiveness of sublingual injection of dexamethasone (8 mg) to treat post-operative pain after mandibular third molar surgery. Method: This was a randomized, double-blind, split-mouth, clinical trial, involving 48 healthy patients who required surgical removal of two mandibular third molars with similar bilateral positions. All operations were performed by the same experienced surgeon. The patients were randomized into a study group (8 mg dexamethasone injection) and a placebo group (normal saline injection). Both interventions were injected into the sublingual space immediately after local anesthesia, 30 min before the first incision. The study group received an 8 mg dexamethasone injection, while the placebo group received a normal saline injection. The wash period between the patients' two operations was 3 to 4 weeks. Pain was assessed by recording the number of analgesic tablets (rescue drug) consumed, as well as by noting the patients' responses to the visual analog scale (VAS) on the first, second, and third days after surgery. Results: The study group differed significantly from the placebo group in terms of VAS score and analgesic consumption. Conclusion: Dexamethasone (8 mg), injected sublingually, significantly eased post-operative pain after surgical removal of the mandibular third molar.

Can single buccal infiltration with 4% articaine induce sufficient analgesia for the extraction of primary molars in children: a systematic literature review

  • Tirupathi, Sunny Priyatham;Rajasekhar, Srinitya
    • Journal of Dental Anesthesia and Pain Medicine
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    • v.20 no.4
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    • pp.179-186
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    • 2020
  • This systematic review aims to determine if a single buccal infiltration (without palatal infiltration in the maxilla and Inferior Alveolar Nerve Block in the mandible) with 4% articaine can induce adequate analgesia for the extraction of primary molars (Maxillary and Mandibular) in children. PubMed, Ovid SP, and Embase were searched for studies published between January 1990 and March 2020 with the relevant MeSH terms. Titles and abstracts were screened preliminarily, followed by the full-texts of the included studies. Five articles were included for this systematic review. The outcome investigated was "Procedural pain during the extraction of primary molars after injection with single buccal infiltration of 4% articaine in comparison to single buccal infiltration, double infiltration (buccal and palatal/lingual), and inferior alveolar nerve block with 2% lignocaine." Of the five studies that evaluated subjective pain during extraction, two reported no significant difference between the articaine and lignocaine groups, and the remaining three reported lower subjective pain during extraction in the articaine group. Only two studies evaluated objective pain scores during extraction, and both studies reported lower pain scores in the articaine group. There is insufficient evidence to justify the statement that a single buccal infiltration of 4% articaine alone is sufficient for the extraction of primary molars. Further evidence is required to justify the claim that palatal infiltrations and IANB can be replaced with the use of 4% articaine single buccal infiltration for the extraction of primary molars in children.

A Research for the Noise Development of the FF 8th Speed Automatic Transmission (전륜 8속 자동변속기 소음 개발에 대한 연구)

  • Lee, Hyun Ku;Hong, Sa Man;Kim, Moo Suk;Hur, Jin Wook;Yoo, Dong Kyu
    • Transactions of the Korean Society for Noise and Vibration Engineering
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    • v.26 no.5
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    • pp.559-566
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    • 2016
  • This study shows a development procedure and results of noise reduction for a new developed FF 8th speed automatic transmission. Based on planetary gear operating frequency analysis using PTA(planetary transmission analysis) program developed in 2012, It is expected that gear noise of the rear planetary gear set could be recognized easily in the concept design stage. Therefore, pRMC (planetary run many cases) analysis program that is developed in 2012 was applied to minimize the planetary gear noise level and noise distributions versus torque. To minimize noises coming from oil pump and final gears of a new transmission, several changes were applied, such as changing the clearance of double angular ball bearing, the oil pump rotor tooth number from 9 to 11 and the oil pump type from parachoid to megafloid and so on. Besides, stiffness values of the transmission case and the mount bracket were measured and reinforced properly. Finally, The total noise of the new FF 8th speed automatic transmission was developed successfully. Furthermore, E.O.L. testers also have been adapted to control the noise quality of automatic transmission assembly in the manufacturing factory. This paper could provide practical solutions to the automatic transmission NVH problems.

The hidden X suture: a technical note on a novel suture technique for alveolar ridge preservation

  • Park, Jung-Chul;Koo, Ki-Tae;Lim, Hyun-Chang
    • Journal of Periodontal and Implant Science
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    • v.46 no.6
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    • pp.415-425
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    • 2016
  • Purpose: The present study investigated the impact of 2 different suture techniques, the conventional crossed mattress suture (X suture) and the novel hidden X suture, for alveolar ridge preservation (ARP) with an open healing approach. Methods: This study was a prospective randomized controlled clinical trial. Fourteen patients requiring extraction of the maxillary or mandibular posterior teeth were enrolled and allocated into 2 groups. After extraction, demineralized bovine bone matrix mixed with 10% collagen (DBBM-C) was grafted and the socket was covered by porcine collagen membrane in a double-layer fashion. No attempt to obtain primary closure was made. The hidden X suture and conventional X suture techniques were performed in the test and control groups, respectively. Cone-beam computed tomographic (CBCT) images were taken immediately after the graft procedure and before implant surgery 4 months later. Additionally, the change in the mucogingival junction (MGJ) position was measured and was compared after extraction, after suturing, and 4 months after the operation. Results: All sites healed without any complications. Clinical evaluations showed that the MGJ line shifted to the lingual side immediately after the application of the X suture by $1.56{\pm}0.90mm$ in the control group, while the application of the hidden X suture rather pushed the MGJ line slightly to the buccal side by $0.25{\pm}0.66mm$. It was demonstrated that the amount of keratinized tissue (KT) preserved on the buccal side was significantly greater in the hidden X suture group 4 months after the procedure (P<0.05). Radiographic analysis showed that the hidden X suture had a significant effect in preserving horizontal width and minimizing vertical reduction in comparison to X suture (P<0.05). Conclusions: Our study provided clinical and radiographic verification of the efficacy of the hidden X suture in preserving the width of KT and the dimensions of the alveolar ridge after ARP.

Comparative, randomized, double-blind clinical study of alveolar ridge preservation using an extracellular matrix-based dental resorbable membrane in the extraction socket

  • Chang, Hyeyoon;Kim, Sulhee;Hwang, Jin wook;Kim, Sungtae;Koo, Ki-Tae;Kim, Tae-Il;Seol, Yang-Jo;Lee, Yong-Moo;Ku, Young;Lee, Jong-Ho;Rhyu, In-Chul
    • Journal of Periodontal and Implant Science
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    • v.47 no.3
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    • pp.165-173
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    • 2017
  • Purpose: The aim of this study was to radiographically and clinically compare the effect of extracellular matrix (ECM) membranes on dimensional alterations following a ridge preservation procedure. Methods: One of 2 different ECM membranes was applied during a ridge preservation procedure. A widely used ECM membrane (WEM; Bio-Gide, Geistlich Biomaterials, Wolhusen, Switzerland) was applied in the treatment group and a newly developed ECM membrane (NEM; Lyso-Gide, Oscotec Inc., Seongnam, Korea) was applied in the control group. Cone-beam computed tomography (CBCT) scans and alginate impressions were obtained 1 week and 6 months after the ridge preservation procedure. Results were analyzed using the independent t-test and the nonparametric Mann-Whitney U test. Results: There were no significant differences between the ECM membranes in the changes in the dimension, width, and height of the extraction socket or the quantity of bone tissue. Conclusions: The NEM showed comparable clinical and radiographic results to the WEM following the ridge preservation procedure.

THE EFFECT OF SUREACE TREATMENTS ON THE REBONDED RESIN-BONDED RETAINERS

  • Kim Sang-Pil;Kang Dong-Wan
    • The Journal of Korean Academy of Prosthodontics
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    • v.40 no.6
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    • pp.590-596
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    • 2002
  • The resin : metal interface is at the basis of most bonding failures in resin-bonded prosthesis. Although debonding has been a problem with adhesive fixed partial dentures, various dentists classify them as long-term restorations. The advantages of resin-bonded fixed partial dentures include minimal tooth reduction and the possibility of rebonding. if resin-bonded protheses can be easily rebounded, it is of clinical importance to know if the lutingagents rebond as well the second time as they did originally. Several retentive systems for resin-to-metal bonding have recommended. Treatments such as electrolytic etching and silicone coating, despite the good result of bond strength, have proved to be time-consuming and technique-sensitive. Therefore a simple and more reliable method is desirable. This study evaluated the effect of metal surface treatments on the rebond strength of panavia 21 cement to a nickel-chromium(Ni-Cr) alloy. The samples were received the following surface treatments : Group No.1 (control or served as the control) treatment with sandblasting with 50um aluminum oxide and ultrasonically cleaned for 10minutes in double-deionized water, Group No.2 were no surface treatments. Group No.3 were treated with metal primer. Group No.4 were treated with sandblasting as previously described, and then metal priming. From the analysis of the results, the following conclusions were drawn. 1. Sandblasting and metal priming appears to be an effective method for treatment of metal after accidental debonding. 2. Group without surface treatment had significantly lower bond strengths compared with other groups. 3. The combination of sandblasting and metal priming may not develop superior bonding strengths compared with other techniques that used the Ni-Cr alloys. 4. Combination of cohesive and adhesive failures were the most common type observed. The results support the use of sandblasting as a viable procedure when rebonding accidentally lost adhesive partial denture. We concluded that sandblasting and metal priming of metal surface before bonding could provide the adequate bond strength during rebonding of resin-bonded fixed partial denture.

Characteristic Analysis for the Reduction Detent Force of Double-sided Slotted Type Permanent Magnet Linear Generator for Wave Energy Conversion (파력에너지 변환용 양측식 슬롯티드 타입 선형 발전기의 디텐트력 저감을 위한 특성해석)

  • Seo, Sung-Won;Choi, Jang-Young;Koo, Min-Mo;Park, Hyung-Il;Hong, Keyyong;Kim, Kyong-Hwan
    • Journal of the Korean Magnetics Society
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    • v.26 no.1
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    • pp.31-37
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    • 2016
  • This study considered the reduction of the detent force of a permanent magnet linear synchronous generator (PMLSG). The PMLSG has a relatively large magnetic air gap. Thus, a slotted type of stator structure is generally employed. Furthermore, the detent force, which is caused by energy imbalances owing to the interaction between tooth-slot structures and the permanent magnets (PMs), must be minimized for start-up operation. Therefore, in this paper, the methods of auxiliary teeth and a notch in the teeth are applied to reduce the detent force.

Coronal tooth discoloration induced by regenerative endodontic treatment using different scaffolds and intracanal coronal barriers: a 6-month ex vivo study

  • Shokouhinejad, Noushin;Razmi, Hassan;Farbod, Maryam;Alikhasi, Marzieh;Camilleri, Josette
    • Restorative Dentistry and Endodontics
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    • v.44 no.3
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    • pp.25.1-25.10
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    • 2019
  • Objective: The aim of this study was to evaluate discoloration of teeth undergoing regenerative endodontic procedures (REPs) using blood clot or platelet-rich fibrin (PRF) as the scaffolds and different calcium silicate-based materials as the intracanal coronal barriers in an ex vivo model. Materials and Methods: Forty-eight bovine incisors were prepared and disinfected using 1 mg/mL double antibiotic paste (DAP). The specimens were then randomly divided into 2 groups (n = 24) according to the scaffolds (blood or PRF). After placement of scaffolds each group was divided into 2 subgroups (n = 12) according to the intracanal coronal barriers (ProRoot MTA or Biodentine). The pulp chamber walls were sealed with dentin bonding agent before placement of DAP and before placement of scaffolds. The color changes (${\Delta}E$) were measured at different steps. The data were analyzed using 2-way analysis of variance. Results: Coronal discoloration induced by DAP was not clinically perceptible (${\Delta}E{\leq}3.3$). Regarding the type of the scaffold, coronal discoloration was significantly higher in blood groups compared with PRF groups at the end of REP and after 1 month (p < 0.05). However, no significant difference was found between PRF and blood clot after 6 months (p > 0.05). Considering the type of intracanal coronal barrier, no significant difference existed between ProRoot MTA and Biodentine (p > 0.05). Conclusions: With sealing the dentinal tubules of pulp chamber with a dentin bonding agent and application of DAP as an intracanal medicament, coronal color change of the teeth following the use of PRF and blood sealed with either ProRoot MTA or Biodentine was not different at 6-month follow-up.