RESUMO
This double-blind, randomized, clinical trial investigated the effectiveness and underlying mechanism of neural inhibition of pulsed Nd:YAG laser induction of pulpal analgesia compared with 5% EMLA anesthetic cream. Forty-four paired premolars from 44 orthodontic patients requiring bilateral premolar extraction from either dental arch were randomly assigned to the 'Laser plus Sham-EMLA' or 'EMLA plus Sham-Laser' treatment group. Analgesia was tested by an Electric Pulp Tester (EPT) and the cutting of a standardized cavity, which was terminated when participants reported sensitivity, and Visual Analogue Scale (VAS) and numbness were recorded. Statistical analyses were done by paired t test, McNemar's test, and a chi-squared test (p < 0.05). Sixty-eight percent of laser- and 59% of EMLA-treated teeth had completed cavities with statistically significant EPT increases above baseline. No significant within-patient differences were found for either group. No laser-treated participants reported numbness. The trial confirmed that the pulsed Nd:YAG laser effectively induced pulpal analgesia, by suppression of intradental nerve responses to electrical and mechanical stimuli. Such a laser provides an alternative for dental pain management (ANZ-Clinical Trial Registry: N12611001099910).
Assuntos
Anestesia Dentária/métodos , Anestesia Local/métodos , Polpa Dentária/efeitos da radiação , Lasers de Estado Sólido/uso terapêutico , Terapia com Luz de Baixa Intensidade/métodos , Adolescente , Anestésicos Combinados/administração & dosagem , Anestésicos Locais/administração & dosagem , Dente Pré-Molar/inervação , Dente Pré-Molar/efeitos da radiação , Preparo da Cavidade Dentária/instrumentação , Polpa Dentária/inervação , Teste da Polpa Dentária/instrumentação , Método Duplo-Cego , Feminino , Humanos , Lidocaína/administração & dosagem , Combinação Lidocaína e Prilocaína , Masculino , Inibição Neural , Medição da Dor , Limiar da Dor/fisiologia , Prilocaína/administração & dosagem , Transmissão Sináptica/efeitos da radiação , Extração DentáriaAssuntos
Assistência Odontológica , Tratamento Farmacológico , Feminino , Humanos , Masculino , Estudos ProspectivosRESUMO
The relevant literature relating to the etiology and treatment of intra-articular ankylosis of the temporomandibular joint is reviewed, and three cases of ankylosis (one unilateral and two bilateral) are reported. Two of these occurred subsequent to trauma, while the other was a manifestation of severe ankylosing spondylitis. They were successfully treated by interpositional arthroplasty with silicone rubber tubing.