Combating inadequate anesthesia in periapical infections, with sodium bicarbonate: a clinical double blind study.

INTRODUCTION: Local anesthetics are generally much less effective when administered in inflamed tissues. PURPOSE: This study was conducted to validate the addition of sodium bicarbonate in local anesthetics to increase its effectiveness as local infiltrations in teeth associated with periapical infections. METHODS: Two hundred subjects requiring extraction of maxillary teeth with periapical infections were enrolled. These subjects were divided in two groups of 100 subjects each. One group received local infiltration with 2 % lignocaine and 1:80,000 adrenaline, and the other group received local infiltration with sodium bicarbonate as an adjunct to the above mentioned local anesthetic solution. All extractions were performed using a consistent intra-alveolar technique by a single operator. Both the patient and the operator were blinded to the contents of local anesthetic solution. Data related to the onset of action of local anesthesia, pain experienced by the patient while undergoing extraction on two scales-"the visual analog scale and the verbal response scale", and any requirement of repeated injections during the procedure was recorded. RESULTS: Clinical and statistical data confirmed that the addition of sodium bicarbonate in local anesthetics did increase the efficacy of local anesthesia in inflamed tissues. CONCLUSION: It has been observed in this study that the action of sodium bicarbonate in local anesthetics increases the pH levels of these solutions, thus possibly making them more effective in an acidic environment.

Effect of inhomogeneous static magnetic field on dental pain in humans.

OBJECTIVES: The aim of this study was to evaluate the pain-inhibitory effect of inhomogeneous static magnetic field (SMF, 0 to 192 mT peak-to-peak magnetic flux density and 19 T/m lateral gradient) exposure on dental pain associated with dentine sensitivity by the quantification of sensory and affective aspects. METHODS: (1) 0 to 10 numerical rating visual analogue scale (NRS) in the first minute of dental treatment following 30 minutes SMF exposure (uncontrolled), and (2) tolerance threshold measurement (TTM) with the help of a pulp meter showing values from 0 to 80 in arbitrary units (step width 10 unit) before and after 30 minutes SMF exposure in 2 sessions: SMF and sham exposure (randomized, double-blind, placebo-controlled). Altogether 59 adult patients (26 males+33 females) representing 62 cases with a mean age of 43.6 years (73% between 20 and 50 y) participated. RESULTS: SMF failed to significantly reduce pain perception in the NRS group and to enhance tolerance threshold in the TTM group. DISCUSSION: Common dental disorders often involve an inflammatory state in the oral environment. Although the relatively low participant number and the uncontrolled manner in case of the NRS examination did not allow drawing unambiguous consequences, it seemed that SMF did not have an effect on healthy patients. The only potential candidate for an effect was, when an inflammatory situation occurred at (or under) the place, where the SMF exposure was targeted. In our case the male participants with caries responded most positively on the SMF treatment.

Factors related to advanced stage oral squamous cell carcinoma in southern Thailand.

A critical factor that indicates a poor prognosis of oral squamous cell carcinoma (OSCC) is advanced stage disease. This study, therefore, aimed to identify the factors related to advanced stage (TNM staging III, IV) OSCC in Thailand. There were 161 patients with squamous cell carcinoma of the oral cavity and lip (ICD-9 140, 141, 143-5), included in the study. Sixty-two per cent of the patients presented with advanced stage disease. Information on demographic characteristics, risk habits, health-seeking behaviour prior to health care professional (HCP) consultation, tumour characteristics and patient and professional delay was obtained by questionnaire-based interview of the patients. These variables were included as initial variables in a logistic regression to calculate the odds ratio (OR) of advanced versus early stage OSCC. Having traditional herbal medication before HCP consultation significantly increased the risk of advanced stage OSCC (OR 5.77; 95% C.I. 1.25-26.62). Floor of mouth location of tumour was associated with a lower risk of advanced stage disease (OR 0.27; 95% C.I. 0.09-0.82) as was having an ulcer (OR 0.43, 95% C.I. 0.02-0.89). The findings indicate that having traditional herbal medication before HCP consultation increased the risk of advanced stage disease. The lower risk of advanced stage OSCC associated with ulcerative tumours and those on the floor of the mouth may be due to their being more readily detected by the patients.

[Personality characteristics of patients with prosopalgias]. / Lichnostnye osobennosti bol'nykh prozopalgiiami.

The MMPI test, Hornblow and Kidson's visual-analog anxiety scale and two types of the painful "questionnaires" suggested by the authors were used to examine the status of emotional personality sphere in 61 patients with prosopalgias due to typical trigeminal neuralgia (n = 39), dental plexalgia (n = 13) and pulpitis (n = 9). It has been revealed that patients with typical trigeminal neuralgia demonstrate the predominance of the depressive syndrome, whereas dental plexalgia is mostly characterized by anxiety. Analysis of the semantic tests is very instrumental in helping the physician to deepen the idea of the structure of subjective sensations in facial pain. Meanwhile the indicators of the "daily pain scale" promote administration of the drugs from the standpoint of chronotherapy.