Extraction of maxillary teeth by dental students without palatal infiltration of local anaesthesia: a randomised controlled trial.

OBJECTIVE: Palatal infiltration of local anaesthesia (LA) for maxillary tooth extractions is painful. One of the techniques for reducing the discomfort of this injection is to avoid it altogether. Given enough time, LA administered only as buccal infiltration diffuses to reach and anaesthetise the palatal tissues. The aim of this double-blind randomised controlled trial was to test the hypothesis that buccal infiltration alone of LA by dental students should be adequate for maxillary tooth extractions. PATIENTS AND METHODS: Fifty adult patients presenting for single-tooth maxillary extractions were randomly allocated between two groups. The control group received palatal injections of 0.1 ml 2% lidocaine with 1:100,000 adrenaline, whilst the experimental group received a similar amount of saline (placebo). Extractions performed without further administration of LA were categorised as successful. RESULTS: Palatal infiltration of lidocaine with adrenaline was significantly more effective than saline (P = 0.002). Overall buccal infiltration alone was successful in 28% patients, with a 40% success rate in the posterior maxilla. CONCLUSION: Results suggest that dental students should, as a matter of routine, extract maxillary teeth with both buccal and palatal infiltration of LA, whilst buccal infiltration alone may be considered in the posterior maxilla.

Effect of adding opaque porcelain on the final color of porcelain laminates.

STATEMENT OF PROBLEM: Increasing the opacity of porcelain laminates is one of the techniques most commonly used to mask the color of darkly stained teeth. PURPOSE OF STUDY: Two different brands of porcelain (Fortune and Optec) disks that contained various amounts of modifying porcelains to alter opacity were cemented with untinted resin cement to a dark colored substrate. MATERIAL AND METHODS: The color of the substrate was measured before and after cementation and the change in color was calculated. RESULTS: Fortune porcelain showed a progressive increase in the amount of change produced as the modifying porcelain was increased, whereas Optec porcelain showed a decrease in the amount of change as modifying porcelain was increased. CONCLUSION: A progressive increase of yellow was exhibited in the samples as the amount of opacity is increased.