Palatal needle-free anesthesia for upper molars extraction. A randomized clinical trial.

BACKGROUND: The aim of this study was to compare the ability of liposomal and non-liposomal lidocaine and prilocaine in hydrogel formulations to promote topical anesthesia in palatal mucosa during upper molar extractions. METHODS: In this randomized, cross over, triple-blinded clinical trial, a liposomal and a non-liposomal formulation of the eutectic mixture of local anesthetics, 2.5% lidocaine and 2.5% prilocaine, were used to promote palatal anesthesia without the local anesthetic infiltration during bilateral upper molars extractions. RESULTS: From the total of 40 patients included in this study, the non-liposomal eutectic lidocaine-prilocaine formulation failed in 40% of cases, unlike the liposomal formulation, which was effective for all patients (Fisher's exact test, p < 0.0001). Furthermore, the liposomal formulation (26.75 ± 7,47 min) induced longer anesthesia duration (t-test, p < 0.0001) than the non-liposomal formulation (16.78 ± 4.75 min). No mucosal ulceration or discomfort was reported for both formulations. CONCLUSION: The liposomal formulation was able to induce adequate anesthesia in palatal mucosa during dental extraction, avoiding the local anesthetic infiltration. For the first time, a topical formulation allowed upper molars surgical removal without injection of any local anesthetic agent into palatal mucosa in adults.

A questão social da fluoretação das águas e a efetivação do direito à saúde / The social issue of water fluoridation and the accomplishment of health rights

A ampliação do conceito de saúde, historicamente acompanhado pelo contexto mundial de globalização da cultura de respeito e proteção dos direitos humanos, influenciou de forma significativa a criação e implementação de dispositivos jurídicos visando à garantia da seguridade social em todos os níveis como condição sine qua non para qualidade de vida e dignidade das pessoas. Nesse sentido, este trabalho tem como objetivo discutir as interfaces do direito que alicerçam a fluoretação das águas em território nacional como mecanismo básico essencial para a promoção de saúde bucal integral, universal e plena.(AU)

The expansion of the concept of health, historically accompanied by the universalization of the culture of respect and protection to human rights in a global context, has significantly influenced the creation and implementation of legal provisions that guarantee social security at all levels as a condition sine qua non for the quality of life and dignity of the individuals. Therefore, the objective of this study is to discuss the interfaces of the law, which underpin water fluoridation in the country as an essential, basic mechanism for promoting integral, universal and comprehensive oral health.(AU)