[TENS as an alternative analgesic treatment in dental settings]. / La TENS quale trattamento antalgico alternativo in ambito odontostomatologico.

The use of electrostimulation using low-intensity and very high frequency current, as an Electronic Analgesic (EDA) has aroused enormous interest during the last few years in Dentistry. Thanks to its use, good results have been obtained especially in the treatment of caries. This technique is suitable for several types of patients as those who have previously shown anaphylactic-anaphylactoid reactions to local anaesthetics, those who are afraid of needle, those who underwent to coronaric by-pass or have had myocardial infarction, those who employ omeophatic therapy and refuse traditional drugs and those who are in anticoagulant therapy, where it is preferable to avoid injection trauma. This technique offers a rapid disappearance of the effects and makes it possible to work in the same sitting on more than one quadrant of the mouth. The application of the technique instead shows relative or absolute contraindications in patients with pace-maker or with an history of alteration of rhythm, cerebral ictus or TIA.

[Safety problems in the use of local anesthetics in the dental area]. / Problemi di sicurezza nell'impiego degli anestetici locali in ambito odontostomatologico.

In the last few years particular attention has been given to the adverse reaction to loco-regional anesthesia now widely used in dental practice. It has seemed therefore interesting to investigate the different types of adverse reactions, with particular attention to the anaphylactic-anaphylactoid ones. Although uncommon, these are interesting for the uncertain pathogenesis, the severity of the clinical picture and the complexity of the treatment. In order to find their adequate prevention, a particular approach to risk patients has been suggested to identify the eventual previous anaphylactic-anaphylactoid reactions and the drugs responsible for it. A procedure based on progressive skin test confirmed by a negative incremental challenge test has been worked out. Moreover the need has been felt for a drug surveillance program capable of collecting computerized data which allows real-time investigation of adverse reaction incidence, their typology and finally the effectiveness of prevention. This procedure should further ensure safety in loco-regional anesthesia in dental practice.

Experimental study of argon laser-induced microthrombosis during PGI2 infusion.

In order to evaluate the Argon laser-induced microthrombogenesis during prostacyclin (PGI2) infusion on newly formed microcirculation in the rabbit ear chamber, time-space parameters have been calculated in 118 observations subdivided into 4 groups according to the type and size of the vessels irradiated. The observations were carried out without drug treatment, with continuous infusion of pH 10.5 glycine buffer and with continuous infusion of PGI2 at the dosage of 125 ng X kg-1 X min-1 diluted in the glycine buffer. The results indicated that during PGI2 infusion the size of the thrombus, measured by maximal thrombus area, was always significantly less extended than in untreated animals. Moreover, the number of emboli detached during the first 5 min after laser exposure, measured by rate of embolization, during PGI2 infusion in venules and in the larger arterioles was smaller than in untreated animals. The vasoconstriction which usually takes place in the arteriolar vessels--upstream and downstream from the irradiated site--was in no way modified by the infusion of PGI2. Finally, it was noted that glycine buffer infusion showed an unforeseen activity on laser-induced vascular reactivity.