Doppler ultrasound to detect pulpal blood flow changes during local anaesthesia.

AIM: To examine whether Doppler ultrasound can detect changes in pulpal blood flow after infiltration anaesthesia. METHODOLOGY: Changes in pulpal blood flow in maxillary central incisor teeth of 18 patients (mean age 26.7 years, 13 men, five women) after infiltration anaesthesia were examined. Before infiltration anaesthesia, the pulpal blood flow was measured using Doppler ultrasound. A local anaesthetic solution containing 2% lidocaine with 1:80,000 epinephrine was injected into the submucosa above the experimental tooth. The Doppler ultrasound test was carried out at 5, 10, 20, 30, 45 and 60 min after infiltration. The parameters were Vas (maximum linear velocity, cm s(-1) ), Vam (average linear velocity, cm s(-1) ) and Vakd (minimum linear velocity, cm s(-1) ), which are indicators of the level of blood flow. The mixed procedure at the 95% confidence interval was used to examine the changes in pulpal blood flow after the injection. RESULTS: The linear velocity profiles (Vas, Vam, and Vakd) decreased sharply 5 min after anaesthesia and then reduced continuously for 30 min. The maximum degree of blood flow reduction in Vas, Vam and Vakd was 58%, 83% and 82%, respectively. After 30 min, the linear velocities increased gradually. The Vam returned to the pre-anaesthesia state at 60 minutes but the Vas and Vakd did not recover completely. CONCLUSIONS: Doppler ultrasound can detect changes in pulpal blood flow after infiltration anaesthesia. In the future, Doppler ultrasound can be used as a tool for measuring pulpal blood flow.

The effect of long-term supplementation of vitamin C on pulpal blood flow in streptozotocin-induced diabetic rats.

To examine the effect of vitamin C on blood flow in diabetic dental pulp, the animal model of streptozotocin (STZ)-induced diabetic rats (i.v. injection of STZ 55 mg/kg BW) was used. Male Sprague-Dawley rats weighing 200-250 g were divided into 3 groups: non-diabetes (CON), diabetes (STZ), and diabetes supplemented by vitamin C (STZ+Vit C). Vitamin C was supplemented by drinking water (1 g/l). At 12 weeks (wks) and 24 wks after the STZ injection, the laser Doppler flow-meter (Model ALF 21, USA) was used to measure pulpal blood flow (PBF) while the animals were anesthetized with sodium pentobarbital (50 mg/kg BW). The experimental results showed that at 12 and 24 wks after the STZ injection, hyperglycemia hypertension and loss of body weight were significantly developed. Simultaneously, decreased plasma vitamin C level was demonstrated significantly in STZ rats. The reduction of pulpal blood flow (PBF) in the lower incisors was observed in STZ rats at both monitored time points. Interestingly, the supplementation of vitamin C for 24 wks restored PBF. In conclusion, the present study demonstrated that long-term supplementation of vitamin C, a natural antioxidant, could markedly prevent the diabetic-induced reduction in PBF.