Assessment of heat generation during implant insertion.

STATEMENT OF PROBLEM: Many studies have investigated the heat generated during implant preparation, but data are needed to better predict heat generation during implant insertion. PURPOSE: The purpose of this study was to measure the heat generated during insertion of an implant at speeds of 30, 50, and 100 rpm, and with manual insertion. MATERIAL AND METHODS: Sixty-four uniform fresh bovine femoral cortical bone specimens were used. After the cortical bone was drilled, 3 different implant insertion speeds and the manual insertion of the implant were evaluated for 2 different implant diameters. The temperature was measured with 2 Teflon-insulated, type K thermocouples. Data were analyzed by 2-way ANOVA, and the Tukey honestly significant difference test (α=.05). RESULTS: The highest thermal change for 4.1-mm-diameter implants was found at a speed of 100 rpm (9.81°C ±2.29°C), and the lowest thermal change was 3.69°C ±0.85°C at a speed of 30 rpm. A statistically significant difference was found between 100 rpm and the other 3 insertion procedures. The highest thermal change for a 4.8-mm-diameter implant was found at a speed of 100 rpm (8.79°C ±1.53°C), and the lowest thermal change was 4.48°C ±0.85°C at a speed of 30 rpm. No statistical difference was observed with manual, 30 rpm, and 50 rpm; however, a statistically significant difference was found between 100 rpm and the other 3 insertion procedures. CONCLUSIONS: Manual implant insertion and at speeds of 30 rpm and 50 rpm generated lower heat compared with insertion at 100 rpm.

Influence of different suturing techniques on periodontal health of the adjacent second molars after extraction of impacted mandibular third molars.

OBJECTIVE: The objective of this randomized controlled trial was to compare the effects of different suturing techniques (simple loop suture vs. anchor suture) on the periodontal health of the adjacent second molars after impacted mandibular third molar extraction. STUDY DESIGN: Fifteen patients with bilaterally identical impacted mandibular third molars were used. Using split-mouth design, flaps were closed with either anchor suture technique or simple loop suture technique after the extraction of third molars. Postoperative examination included probing pocket depth (PPD) and clinical attachment level (CAL) measured at the distal surface of the second molars before surgery and 6 months after surgery. RESULTS: The PPD and CAL in the distal surfaces of the second molars were significantly higher after 6 months in the simple suture group (P = .001), whereas no differences were found in the anchor suture group (P > .05). Intergroup comparisons showed that the 6-month PPD and CAL values of the distal surfaces were significantly higher in the simple suture group compared with the anchor suture group (P = .015). CONCLUSION: The results suggest that anchor suture might be a better technique to use to maintain healthy periodontium and to prevent periodontal problems after the extraction of impacted third molars.

A comparison of injection pain with articaine with adrenaline, prilocaine with phenylpressin and lidocaine with adrenaline.

OBJECTIVE: The objective of the present study was to investigate the pain on injection of articaine with adrenaline, prilocaine with phenylpressin , and lidocaine with adrenaline. STUDY DESIGN: The study sample was comprised of 497 consecutively seen patients received 497 maxillary buccal infiltration injections or inferior alveolar block injections of 4% articaine with 1:200.000 adrenaline, 3% prilocaine with 1.08 mcg phenylpressin, or 2% lidocaine with 1:100.000 adrenaline. Immediately after the injection, patients were asked to rate their injection pain on a six-point scale. RESULTS: There were no significant differences among the anesthetic solutions for injection pain. Patients usually reported mild or no injection pain for all of anesthetic administrations. CONCLUSION: Under the conditions of this study that lidocaine with adrenaline, articaine with adrenaline and prilocaine with phenylpressin seemed to be similar for pain on injection and they could be quite painless.

A comparison of injection pain with articaine with adrenaline, prilocaine with phenylpressin and lidocaine with adrenaline

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Objective: The objective of the present study was to investigate the pain on injection of articaine with adrenaline, prilocaine with phenylpressin , and lidocaine with adrenaline. Study Design: The study sample was comprised of 497consecutively seen patients received 497 maxillary buccal infiltration injections or inferior alveolar block injections of 4% articaine with 1:200.000 adrenaline, 3% prilocaine with 1.08mcg phenylpressin, or 2% lidocaine with 1:100.000 adrenaline. Immediately after the injection, patients were asked to rate their injection pain on a six-point scale. Results: There were no significant differences among the anesthetic solutions for injection pain. Patients usually reported mild or no injection pain for all of anesthetic administrations.Conclusion: Under the conditions of this study that lidocaine with adrenaline, articaine with adrenaline and prilocaine with phenylpressin seemed to be similar for pain on injection and they could be quite painless

Comparison of the Wand with a conventional technique.

OBJECTIVE: The objective of the present study was to compare the Wand computer-controlled anesthetic delivery system with a conventional technique as to pain of needle insertion and the pain during injection according to the patient's dental anxiety levels. STUDY DESIGN: The study sample comprised 52 healthy patients about to undergo routine tooth extraction. A dental anxiety scale was used to determine anxiety levels before anesthetic administration. Anesthesia technique selection was made according to the patients' anxiety level. After each injection, patients completed pain rating score and visual analog scale to rate their pain perception during needle insertion and injection. RESULTS: The patients receiving the Wand system reported significantly less pain of needle insertion and less pain during injection (P < .05). CONCLUSION: Under the conditions of this study, although the anxiety levels of patients were higher in Wand injection than conventional syringe injection, the Wand seemed to be less painful. However, the mean ratings of pain were mostly mild or no pain for both injections.