Is nasopalatine nerve block still mandated for the extraction of maxillary anterior teeth?

Aim This study was conducted to investigate the effectiveness of a single labial injection of 4% articaine for the extraction of maxillary anterior teeth without the need for nasopalatine supplementary injection.Materials and methods A prospective, controlled, split-mouth clinical study was performed to evaluate the clinical performance of 4% articaine as a single labial infiltration anaesthesia for the extraction of maxillary anterior teeth and to compare it with the routine method of labial injection along with a supplementary nasopalatine injection using 2% lidocaine. Statistical analyses were performed, with the statistical significance being set at 5% level.Results A total of 37 patients met the inclusion criteria, and a statistically significant difference was observed in the reported pain during injection between the single labial articaine injection and the routine labial and palatal lidocaine injections (P <0.001). The extraction of maxillary anterior teeth was possible without the need for an additional nasopalatine injection in all the study patients (n = 37). The difference between both groups was statistically non-significant in terms of the pain encountered during extraction (P = 0.22).Conclusion With the use of 4% articaine as a single labial infiltration anaesthesia, nasopalatine nerve block for the extraction of maxillary anterior teeth may become an outdated modality.

Evaluation of orbital volume after orbitozygomatic complex fractures fixation: A radiographical study.

BACKGROUND: Orbitozygomatic complex fractures are one of the most commonly encountered injuries of the craniofacial skeleton. The aim of this study was to implement the orbital volume as an objective evaluation modality for the assessment of the accuracy of unilateral Orbitozygomatic complex fracture fixation, by comparing the postoperative values with the contralateral normal side and the pretreated values. MATERIALS AND METHODS: A retrospective radiographic, chart review was performed in order to investigate the primary outcome of the objective quantification of the accuracy of Orbitozygomatic complex fracture reduction utilizing orbital volume analysis. Comparing the postoperative orbital volume values with the preoperative, and the contralateral normal ones was set as the study secondary outcome, along with the percentage of changes in the orbital volume of unilateral Orbitozygomatic complex fracture treated patients. Data reliability was performed using Interclass correlation coefficient and Statistical significance was set at 5% level. RESULTS: Seventeen records met the inclusion criteria. While a statistically significant difference was found between the preoperative orbital volume values of the affected side and that in the normal unaffected side (P < 0.001), a statistically insignificant difference was encountered between the postoperative values and the control side (P = 0.333). An average percentage of decrease of 6.1%. was reported in the postoperative records when compared to the preoperative ones, with a statistically significant difference (P < 0.001). the study reported high inter (ICC = 0.97) and Intra (ICC = 0.97) observer reliability. CONCLUSION: Orbital volume analysis offers a valid modality for the objective evaluation of the efficiency of Orbitozygomatic complex fracture management.