A Comparison between Inferior Alveolar Nerve Block and Crestal Anesthesia in Children Undergoing Dental Extraction Procedure

ABSTRACT Objective: To evaluate the efficacy of crestal anesthesia compared to the inferior alveolar nerve block (IANB) in 6-9-year-old children undergoing tooth extraction. Material and Methods: This case-control study was conducted on 70 children who needed bilateral mandibular primary molar extractions. The Faces Pain Scale was used to determine the efficacy of the anesthetic technique. Demographic data, onset time of anesthesia, duration of anesthesia, and blood pressure were also recorded. The data were analyzed using SPSS 25 and analytical tests: t-test, chi-squared test, and one-way ANOVA. The level of significance was set at p<0.05. Results: The efficacy of the IANB was significantly higher than the crestal anesthesia (p<0.05). The duration of IANB anesthesia was significantly more than the crestal anesthesia (p<0.05). The two anesthetic techniques showed no significant differences in pediatric blood pressure as a determinant of the pain evoked in children during the injection (p>0.05). Conclusion: Crestal anesthesia proved an effective method to extract primary molars. However, further studies are necessary to confirm this.

Oral Manifestations and Dental Management Considerations of Lipoid Proteinosis: A Case Report and Review of Literature.

Lipoid proteinosis (LP) is a sporadic congenital metabolic disorder characterized by deposition of hyaline material in various organs. It has a very low prevalence rate of approximately 300 cases reported up to now. It has a vast spectrum of manifestations ranging from asymptomatic skin lesions to the rare but life-threatening laryngeal obstruction. The knowledge of the clinical features of the disease such as hoarseness of voice from infancy, mucocutaneous manifestations, moniliform blepharosis (multiple, beaded papules along the eyelash line) and dental anomalies such as hypoplasia or aplasia of teeth may help oral health care practitioners improve the quality of their patient's life. This case report describes a typical 10-year-old boy who presented to the Department of Pediatric Dentistry, Faculty of Dentistry, University of Medical Sciences, Kerman, Iran with the typical recurrent skin and mucosal lesions, hoarseness, and blepharosis. In addition, he stated a gradual hearing loss, which is not reported as a common manifestation. Moreover, psychosocial issues regarding his appearance and quality of voice had led to absenteeism from school. A punch biopsy obtained from a lesion on his forearm revealed the characteristic histopathological view and directed to the diagnosis of lipoid proteinosis. Dental treatment was initiated with focus on preventive dentistry due to the restricted mouth opening, which was expected to get worse overtime. There is no definitive cure for this disease and the treatment is symptomatic in most cases. A proper workup can result in early diagnosis and management of dental complications, which are difficult to control due to restricted mouth opening, which may significantly affect the patient's social life.