Excisional Biopsy of the Pyogenic Granuloma in Very High-Risk Patient.

Oral surgery to remove pyogenic granuloma in a high-risk patient is reported. A 47-year-old man with gastroesophageal reflux disease, diabetes mellitus II, dyslipidemia, and chronic coronary insufficiency (myocardial infarction within 2 years) with episodes of unstable angina was submitted to an excisional biopsy of hemorrhagic lesion in the lingual right mandibular gingiva. During dental treatment, the arterial blood pressure, oxygen saturation, heart rate, and electrocardiogram were monitored. Local anesthesia was performed with 0.45 ml of 3% prilocaine with 0.03 IU/ml felypressin. The anticoagulant therapy was not interrupted. No local or systemic complications were noticed during or after the surgery.

Anaesthetic efficacy of unilamellar and multilamellar liposomal formulations of articaine in inflamed and uninflamed tissue.

We compared the efficacy of articaine encapsulated in multilamellar and unilamellar liposomes with that of articaine with epinephrine, after infiltration into inflamed and uninflamed tissue in rats. We encapsulated 4% articaine in multilamellar (articaine:multi) and unilamellar (articaine:uni) liposomes and compared them with 4% articaine with 1:100 000 epinephrine (articaine:epinephrine), in inflamed (plantar incision into the hind paw) and uninflamed (infraorbital nerve block) tissue in rats. Anaesthetic formulations (0.1ml) were injected near the right infraorbital foramen in uninflamed tissue, where success and duration of anaesthesia were assessed by pinching the upper lip every 5 minutes. For inflamed tissue the anaesthetic formulations (0.1ml) were injected laterally into a surgical wound made 24 hours earlier in the plantar region of the rat's right hind paw. The degree of anaesthesia was assessed by application of forces laterally to the wound with electronic von Frey filaments. Articaine:uni resulted in less successful anaesthesia than both articaine:multi (p=1.1x10(-5)) and articaine:epinephrine (p=4.3x10(-8)) in uninflamed tissue, but there were no differences in duration or success of anaesthesia between articaine:epinephrine and articaine:multi. In inflamed tissue articaine:epinephrine gave significantly more effective anaesthesia for longer than articaine:uni (p=2.3x10(-6)), and articaine:epinephrine (p=1.8x10(-6)) formulations, which did not differ from each other. Multilamellar liposomal articaine could be an option for local anaesthesia in uninflamed tissues. However, articaine with epinephrine gave better results than liposomal formulations in inflamed tissue.

Revisão das Diretrizes da ABENO para a definição do Estágio Supervisionado Curricular nos cursos de Odontologia / ABENO's review of the Guidelines to define the Supervised Curricular Internship in Dental courses

O estágio curricular supervisionado é objeto de lei e de avaliação dos cursos de graduação em Odontologia pelo Ministério da Educação do país. A regulamentação deste componente curricular é amparada por diferentes segmentos de regulação da formação profissional do cirurgião dentista. A Associação Brasileira de Ensino Odontológico (ABENO) por meio da sua Comissão de Ensino divulgou as primeiras diretrizes acerca do assunto em 2002 e apresenta a revisão destas diretrizes à luz da legislação vigente e das melhores práticas educacionais para atendimento ao perfil do egresso preconizado pelas Diretrizes Curriculares Nacionais (DCN) para o curso de graduação em Odontologia. Assim, são apresentadas 12 diretrizes da ABENO para a definição do estágio curricular supervisionado nos cursos de graduação em Odontologia (AU).

The supervised traineeship is a law object in the evaluation of Dental undergraduate courses in Brazil, by the country's Ministry of Education. The regulation of this curricular component exists in several documents provided by different segments of regulating the training of dentists. The Brazilian Association of Dental Education (Associação Brasileira de Ensino Odontológico - ABENO), through its Education Commission, issued the first guidelines on this subject in 2002, and presents a review of these guidelines in the light of current legislation and best educational practices to meet the profile of the recommended egress by the Guidelines National curriculum for undergraduate Dental course. Thus, they present 12 ABENO guidelines for the definition of curricular supervised training in undergraduate courses in dentistry (AU).

Suporte básico de vida e ressuscitação cardiopulmonar em adultos: conceitos atuais e novas recomendacões / Basic life support and cardiopulmonar ressuscitation for adults: latest guidelines and new recommendations

Compete ao cirurgião-dentista reconhecer as situações de emergência que colocam em risco a saúde e a vida de seus pacientes, instituindo medidas de pronto atendimento. Entretanto, muitos destes profissionais se sentem inseguros para lidar com tais situações, algumas delas tão críticas que cada segundo desperdiçado pode levar à piora do quadro clínico, inclusive com risco de morte. Este artigo tem por objetivo ressaltar a importância da capacitação do cirurgião-dentista em lidar com as emergências médicas, bem como apresentar as mais recentes diretrizes da American Heart Association em relação ao Suporte Básico de Vida e Ressuscitação Cardiopulmonar para pacientes adultos, complementadas pelas instruções de uso do desfiblilador automático externo.

Dentists are responsible for recognize and need to be prepared to deal with medical emergencies during dental procedures, which include the knowledge in basic life support (BLS), cardiopulmonar ressuscitation (CPR) and the use of an automated external deffibrilator (AED). This study guide is intended to give the reader a focused review of the importance of the training in BLS and CPR, informing the modifications of the latest guidelines of American Heart Association for adult patients.

Articaine (4%) with epinephrine (1:100,000 or 1:200,000) in intraosseous injections in symptomatic irreversible pulpitis of mandibular molars: anesthetic efficacy and cardiovascular effects.

OBJECTIVE: The aim of this study was to compare the cardiovascular effects and the anesthetic efficacy of intraosseous injections of 4% articaine with 1:100,000 epinephrine (EPI100) or 4% articaine with 1:200,000 epinephrine (EPI200). STUDY DESIGN: In this prospective, randomized, double-blind study, 0.9 mL EPI100 and EPI200 solutions were administered for endodontic treatment of mandibular molars with symptomatic irreversible pulpitis in 60 patients. The anesthetic success and pain during anesthesia were evaluated by visual analog scale. The cardiovascular parameters evaluated were heart rate, diastolic/systolic blood pressure, pulse oximetry, and electrocardiogram changes. RESULTS: Both solutions provided high anesthetic efficacy (96.8% and 93.1% for EPI100 and EPI200, respectively; P > .05), and the cardiovascular parameters showed minimal incidences of significant differences throughout the clinical procedure. CONCLUSIONS: The epinephrine concentration did not affect the efficacy of 4% articaine, and both solutions produced a high success level of pulpal anesthesia. Intraosseous delivery by slow speed of injection did not induce significant clinical changes in cardiovascular parameters.

Micro and nanosystems for delivering local anesthetics.

INTRODUCTION: One of the most common strategies for pain control during and after surgical procedures is the use of local anesthetics. Prolonged analgesia can be safely achieved with drug delivery systems suitably chosen for each local anesthetic agent. AREAS COVERED: This review considers drug delivery formulations of local anesthetics designed to prolong the anesthetic effect and decrease toxicity. The topics comprise the main drug delivery carrier systems (liposomes, biopolymers, and cyclodextrins) for infiltrative administration of local anesthetics. A chronological review of the literature is presented, including details of formulations as well as the advantages and pitfalls of each carrier system. The review also highlights pharmacokinetic data on such formulations, and gives an overview of the clinical studies published so far concerning pain control in medicine and dentistry. EXPERT OPINION: The design of novel drug delivery systems for local anesthetics must focus on how to achieve higher uploads of the anesthetic into the carrier, and how to sustain its release. This comprehensive review should be useful to provide the reader with the current state-of-art regarding drug delivery formulations for local anesthetics and their possible clinical applications.

Methylparaben concentration in commercial Brazilian local anesthetics solutions.

OBJECTIVE: To detect the presence and concentration of methylparaben in cartridges of commercial Brazilian local anesthetics. MATERIAL AND METHODS: Twelve commercial brands (4 in glass and 8 in plastic cartridges) of local anesthetic solutions for use in dentistry were purchased from the Brazilian market and analyzed. Different lots of the commercial brands were obtained in different Brazilian cities (Piracicaba, Campinas and São Paulo). Separation was performed using high performance liquid chromatography (HPLC) with UV-Vis detector. The mobile phase used was acetonitrile:water (75:25 - v/v), pH 4.5, adjusted with acetic acid at a flow rate of 1.0 ml.min-1. RESULTS: When detected in the solutions, the methylparaben concentration ranged from 0.01% (m/v) to 0.16% (m/v). One glass and all plastic cartridges presented methylparaben. CONCLUSION: 1. Methylparaben concentration varied among solutions from different manufacturers, and it was not indicated in the drug package inserts; 2. Since the presence of methylparaben in dental anesthetics is not regulated by the Brazilian National Health Surveillance Agency (ANVISA) and this substance could cause allergic reactions, it is important to alert dentists about its possible presence.

Methylparaben concentration in commercial Brazilian local anesthetics solutions

OBJECTIVE: To detect the presence and concentration of methylparaben in cartridges of commercial Brazilian local anesthetics. MATERIAL AND METHODS: Twelve commercial brands (4 in glass and 8 in plastic cartridges) of local anesthetic solutions for use in dentistry were purchased from the Brazilian market and analyzed. Different lots of the commercial brands were obtained in different Brazilian cities (Piracicaba, Campinas and São Paulo). Separation was performed using high performance liquid chromatography (HPLC) with UV-Vis detector. The mobile phase used was acetonitrile:water (75:25 - v/v), pH 4.5, adjusted with acetic acid at a flow rate of 1.0 ml.min-1. RESULTS: When detected in the solutions, the methylparaben concentration ranged from 0.01% (m/v) to 0.16% (m/v). One glass and all plastic cartridges presented methylparaben. CONCLUSION: 1. Methylparaben concentration varied among solutions from different manufacturers, and it was not indicated in the drug package inserts; 2. Since the presence of methylparaben in dental anesthetics is not regulated by the Brazilian National Health Surveillance Agency (ANVISA) and this substance could cause allergic reactions, it is important to alert dentists about its possible presence.

The influence of local anesthetic solutions storageon tissue inflammatory reaction

Objective: This study aimed to analyze the influence of storage conditions of local anesthetic solutions in the inflammatory reaction after injection in rats. Study design: Twenty-four rats received in their oral mucosa the injection of 2% lidocaine with epinephrine1:100.000 solutions (LA) submitted to the following storage conditions during a twelve-month period: G1 - insidethe original packaging, in refrigerator (5±1°C); G2 - inside the original box, under light shelter, at room temperature;G3 - outside the original box at room temperature (exposed to artificial light for 12 hours/day) and G4 - brandnew solution. For the controls tests, 0.9% sodium chloride solution was injected in the opposite side. After 6 and24 hours, three animals of each group were sacrificed and their maxilla along with the soft tissue were removed and submitted to histological analysis (HE). Results: The pH of LA was measured before and after the storage period and no statistically differences were observed between G1 and G4, but both were different from G2 and G3. All the scores of the testing solutions were higher than their respective negative controls, except for G1 at 6 hours. The order of the scores of inflammation after 6 hours was G3>G4>G2=G1. After 24 hours the order was G3>G2>G1>G4. Conclusion: The study showed that the method of storage can influence the pH and the level of inflammatory reaction after the injection of 2% lidocaine with epinephrine 1:100.000 (AU)

Anesthetic efficacy of liposomal prilocaine in maxillary infiltration anesthesia.

Animal studies have shown that liposome encapsulation increases prilocaine anesthetic efficacy. This randomized, blind, crossover, three-period study evaluated the anesthetic efficacy of liposome-encapsulated 3% prilocaine, compared to 3% plain prilocaine and 3% prilocaine with 0.03IU/mL felypressin, after a 1.8-mL infiltration in the buccal sulcus of the maxillary right canine, in 32 volunteers. Anesthesia success, onset, and duration of pulpal and gingival anesthesia in the lateral incisor, and canine and first premolar were evaluated. Injection pain was assessed by a visual analog scale (VAS). Results were submitted to Kruskal-Wallis (onset and duration of pulpal anesthesia), Tukey (VAS), Friedman (duration of gingival anesthesia), and log-rank and McNemar tests (anesthesia success) (α = 5%). Liposomal prilocaine did not differ from plain prilocaine (P > 0.05), but presented lower anesthesia success and duration for canine, premolar, and gingival anesthesia (P < 0.05) than prilocaine with felypressin. Liposomal prilocaine did not differ from the other formulations concerning onset and anesthesia success for the lateral incisor (p > 0.05); plain prilocaine presented lower success rates and slower onset of anesthesia for this tooth, in comparison to prilocaine with felypressin (P < 0.05). No differences were observed among the formulations in relation to duration of anesthesia for lateral incisor, VAS scores, and onset of gingival and pulpal anesthesia for the canine and premolar (P > 0.05). In conclusion, liposomal prilocaine presents similar anesthetic efficacy in relation to plain prilocaine and lower efficacy, in comparison to prilocaine with felypressin in maxillary infiltration. Prilocaine does not seem to benefit from liposomal encapsulation.

Efficacy of liposome-encapsulated mepivacaine for infiltrative anesthesia in volunteers.

This blinded crossover study evaluated the efficacy and pain sensitivity evoked by a previously reported liposome-encapsulated mepivacaine formulation (Araujo et al., 2004). Thirty healthy volunteers received an intraoral injection (1.8 mL), at four different sessions, of the following formulations: 2% mepivacaine with 1:100,000 epinephrine (MVC(2%EPI)), 3% mepivacaine (MVC(3%)), and 2 and 3% liposome-encapsulated mepivacaine (MVC(2%LUV) and MVC(3%LUV)). Latency period and duration of anesthesia were assessed by an electrical pulp tester and injection discomfort by a visual analog scale (VAS). Data were analyzed with Tukey-Kramer and Friedman tests (P < 0.05). No significant difference was found regarding latency period (in minutes) among the formulations (P > 0.05). The duration of anesthesia after the injection of MVC(3%LUV) was higher than the one obtained after the infiltration of MVC(2%LUV) and of MVC(3%) (P < 0.05). However, the duration of anesthesia obtained with MVC(3%) did not differ from the one obtained with MVC(2%LUV) (P > 0.05). MVC(3%LUV) showed lower VAS median values than MVC(2%EPI) (P < 0.05), and there were no significant differences among the others formulations. Liposome-encapsulated 3% mepivacaine showed longer duration of anesthesia, in comparison to the commercial formulation of MVC(3%). MVC(2%LUV) was able to produce a similar duration of anesthesia as the 3% commercial formulation, despite the 50% decrease in the anesthetic concentration. Thus, the encapsulation of mepivacaine increased the duration of anesthesia and reduced the injection discomfort caused by vasoconstrictor-associated formulations in healthy volunteers.

The influence of local anesthetic solutions storage on tissue inflammatory reaction.

OBJECTIVE: This study aimed to analyze the influence of storage conditions of local anesthetic solutions in the inflammatory reaction after injection in rats. STUDY DESIGN: Twenty-four rats received in their oral mucosa the injection of 2% lidocaine with epinephrine 1:100.000 solutions (LA) submitted to the following storage conditions during a twelve-month period: G1--inside the original packaging, in refrigerator (5±1°C); G2--inside the original box, under light shelter, at room temperature; G3--outside the original box at room temperature (exposed to artificial light for 12 hours/day) and G4--brand new solution. For the controls tests, 0.9% sodium chloride solution was injected in the opposite side. After 6 and 24 hours, three animals of each group were sacrificed and their maxilla along with the soft tissue were removed and submitted to histological analysis (HE). RESULTS: The pH of LA was measured before and after the storage period and no statistically differences were observed between G1 and G4, but both were different from G2 and G3. All the scores of the testing solutions were higher than their respective negative controls, except for G1 at 6 hours. The order of the scores of inflammation after 6 hours was G3>G4>G2=G1. After 24 hours the order was G3>G2>G1>G4. CONCLUSION: The study showed that the method of storage can influence the pH and the level of inflammatory reaction after the injection of 2% lidocaine with epinephrine 1:100.000.

Liposome-encapsulated ropivacaine for intraoral topical anesthesia.

OBJECTIVES: This study evaluated the efficacy of liposome-encapsulated 2% ropivacaine in topical anesthesia and its influence on pulpal response. STUDY DESIGN: Forty volunteers received the following topical formulations in the buccal fold of the maxillary lateral incisors region (bilaterally): liposome-encapsulated 2% ropivacaine gel (RL2); 20% benzocaine gel (B20); liposomal placebo gel (LP); and placebo gel (P). Formulations were kept in place for 30 minutes, during which time the teeth were electric pulp tested every 10 minutes. After this procedure, a dental needle was inserted until periosteum contact in the same site of topical application and pain was rated by a visual analog scale. Duration of soft tissue anesthesia was assessed by pinprick test. RESULTS: RL2 and B20 showed lower pain response to needle insertion and longer soft tissue anesthesia then P and LP (P = .0003 and P < .0001, respectively); however, RL2 was not different from B20 (P > .05) regarding those parameters. None of the formulations was able to induce pulpal anesthesia. CONCLUSION: RL2 was as effective as B20 in reducing pain during needle insertion and inducing soft tissue anesthesia; however, neither one was able to induce pulpal anesthesia after a 30-min application.

Liposomal encapsulation improves the duration of soft tissue anesthesia but does not induce pulpal anesthesia.

STUDY OBJECTIVE: To compare the topical and the pulpal anesthesia efficacy of liposomal and plain benzocaine formulations. DESIGN: Double-blinded, randomized crossover study. SETTING: University ambulatory dental center. PATIENTS: 30 ASA physical status I volunteers. INTERVENTIONS: Volunteers received, in three different sessions, topical application of liposome-encapsulated 10% benzocaine (LB10), 10% benzocaine gel (B10), and 20% benzocaine gel (B20) in the right maxillary canine mucobuccal fold. MEASUREMENTS: Pain associated with the needle insertion was rated by visual analog scale (VAS) and the duration of topical anesthesia was recorded. Pulpal anesthesia was evaluated using an electric pulp tester. MAIN RESULTS: VAS values (median, 1st - 3rd quartiles) were 17 cm (11 - 25), 14 cm (3 - 22), and 21 cm (9 - 21) for B10, LB10, and B20, respectively. No differences were noted among the groups (Friedman test; P = 0.58). Soft tissue anesthesia was also not different. The LB10 [10 (8 - 12) min] showed longer soft tissue anesthesia (Friedman test; P < 0.01) than the other agents [B10 = 8 (5 - 10) min, and B20 = 7 (6 - 9) min]. None of the topical benzocaine formulations tested induced pulpal anesthesia. CONCLUSIONS: The encapsulation of benzocaine into liposome increased the duration of soft tissue anesthesia. However, it did not induce pulpal anesthesia.

Anesthetic efficacy of articaine and lidocaine for incisive/mental nerve block.

INTRODUCTION: The incisive/mental nerve block (IMNB) could be an alternative to the inferior alveolar nerve block in the mandibular anterior teeth. The effectiveness of articaine has not been tested in IMNB. METHODS: This prospective randomized double-blind crossover study compared the anesthetic efficacy of 0.6 mL 4% articaine and 2% lidocaine, both with 1:100.000 epinephrine administered as IMNB to 40 volunteers in two sessions. Pulpal anesthesia of lateral incisor through premolars was tested with an electric pulp tester. The injection and postoperative pain were evaluated by using visual analog scales. The onset (time from the end of injection to the absence of pulpal response) and duration of pulpal anesthesia (time recorded before two positive responses to the pulp tester) and the anesthesia success (two consecutive readings of 80 without response and onset0.05). CONCLUSIONS: Articaine promoted higher anesthesia success and longer duration of anesthesia than lidocaine for most of the teeth after IMNB although anesthesia success could be considered clinically appropriated only for premolars. The volume of local anesthetic used in the present study may not be appropriate for procedures lasting longer than 10 minutes.

Pharmacokinetic and local toxicity studies of liposome-encapsulated and plain mepivacaine solutions in rats.

The pharmacokinetics and the local toxicity of commercial and liposome-encapsulated mepivacaine formulations injected intra-orally in rats were studied. Animals were divided in groups (n = 4-6) and treated with 0.1 mL of the formulations: 2% mepivacaine with 1:100,000 epinephrine (MVC(2%EPI)), 3% mepivacaine (MVC(3%)), and 2% liposome-encapsulated mepivacaine (MVC(LUV)). The results showed that the 2% liposome-encapsulated mepivacaine reduced C(max), prolonged AUC(0-infinity) and t(1/2) compared with 3% plain and 2% vasoconstritor-associated mepivacaine, after intraoral injection. In addition, it was also observed that liposomal mepivacaine might protect the tissue against local inflammation evoked by plain or vasoconstrictors-associated mepivacaine, giving supporting evidence for its safety and possible clinical use in dentistry.

Cirurgia de terceiro molar sob sedação com óxido nitroso: avaliação subjetiva e cardiovascular / Nitrous oxide sedation in oral surgery: subject perception and cardiovascular monitoring

Este estudo teve por objetivo avaliar o grau de aceitação, a ansiedade e a variação de frequência cardíaca (FC), saturação de oxigênio (SpO) e pressão arterial sistólica (PAS) e diastólica (PAD) em cirurgias de terceiros molares com e sem sedação consciente com óxido nitroso e oxigênio (N2O/ 02). Vinte voluntários saudáveis com necessidade de extração dos terceiros molares bilaterais participaram do estudo, o qual foi realizado em três fases: Fase A - N2O/ 02 sem intervenção odontológica; Fases B e C - exodontia de um dos lados, de forma aleatória, com (C-N2O) ou sem (S-N2O) sedação associada. Para definir o grau de ansiedade utilizou-se a Escala de Ansiedade Dental de Corah (EADC); a sensação dolorosa foi quantificada pela Escala de 11 pontos em caixa (EC); e o grau de aceitação da sedação pelo questionário subjetivo (QS). 60% dos voluntários deram nota máxima para C-N2O e todos os voluntários afirmaram que a sessão C-N2O foi mais agradável. O relato de dor após a sessão C-N2O foi menor ou igual à da sessão S-N2O para 85% dos voluntários. A FC apresentou diferença significante entre as fases C-N2O e S-N2O, diferentemente da Sp02, PAD e PAS. Concluiu-se que os voluntários mostraram-se moderadamente ansiosos em todas as fases, sendo a sessão C-N2O mais agradável que S-N20, a C-N20 reduziu significativamente a FC, mas não influenciou na PAS, PAD e Sp02. A C-N20 não alterou a sintomatologia dolorosa durante e após a cirurgia.

The purpose of this study was to evaluate the changes of heart rate (HR), oxygen saturation (SpO) and both diastolic (DBP) and systolic (SBP) blood pressure, anxiety and acceptance of nitrous oxide conscious sedation (N2O/ 0) in three phases: A - N2O/02 without surgery; B and C - extraction of one of the sides with (C-N2O) or without (S-N2O) nitrous oxide sedation, in a random cross-over manner. Twenty healthy volunteers, average age of 20.55 years, undergoing removal of third molars were selected. Corah's Dental Anxiety Scale (CDS); Eleven points in box Scale (EC) and subject questionnaire (QS) was used to evaluation. The comparative values between phases were analyzed by Wilcoxon's and Friedman's test (= 0,05) and by explorative analysis (QS). The volunteers moderately revealed anxious in all the phases and 60% of volunteers had given maximum note for C-N2O. All volunteers had affirmed that C-N2O was more pleasant. The pain report after the C-N2O was lesser or equal for 85% of volunteers. The HR presented significant difference between phases C-N2O and S-N2O (p= 0.020). There were no significant statistical differences between phases to SpO2 (p= 0.153), DBP (p= 0.730) and SBP (p= 0.975). These results suggest that C-N2O was most pleasant and reduced the HR significantly, but it did not influence in the SBP, DBP and Sp02, nor modified the pain during or after surgery.

Anesthetic efficacy of 3 volumes of lidocaine with epinephrine in maxillary infiltration anesthesia.

The objective of this randomized double-blind investigation was to compare the anesthetic efficacy and injection discomfort of 3 volumes of 2% lidocaine with 1:100,000 epinephrine for maxillary infiltration anesthesia. A total of 25 subjects received 0.6, 0.9, and 1.2 mL of the anesthetic buccal to an upper canine. Test teeth were assessed with electrical stimulation to determine onset and duration of pulpal anesthesia; soft tissue anesthesia and injection discomfort were assessed by pin-prick test and visual analog scale (VAS). Data were analyzed by 2-way analysis of variance (ANOVA), Friedman, and chi-square tests (alpha = 5%). The 1.2 mL dose induced faster onset of pulpal anesthesia, a higher success rate, and a longer duration of soft tissue/pulpal anesthesia than were achieved with the other doses (P < .05). No differences in injection discomfort were observed between treatments. It is concluded that maxillary infiltration anesthesia with lidocaine and epinephrine has a faster onset, a greater success rate, and a longer duration when a volume of 1.2 mL is used than when volumes less than 1.0 mL are used.

Avaliação do nível de ansiedade e dor de pacientes em urgências endodônticas e sua influência sobre parâmetros cardiovasculares / Evaluation of anxiety and pain levels in patients with endodontic urgency and influence in cardiovascular parameters

O objetivo do trabalho foi avaliar a influência da dor e ansiedade sobre a freqüência cardíaca (FC) e pressão arterial (PA) de 275 voluntários em situações de urgências endodônticas, selecionados de forma aleatória, entre os pacientes que procuraram o serviço do Pronto Socorro Odontológico da Faculdade de Odontologia da Universidade Federal de Uberlândia (FOUFU). Os voluntários responderam a ficha de anamnese e a Escala de Ansiedade Dental de Corah ainda na sala de espera. A Escala de 11 Pontos em Caixa foi usada para avaliar a sensação dolorosa dos voluntários, em dois momentos: antes do atendimento, para determinar a dor com que chegaram para atendimento e, após o tratamento, para determinar se houve alteração na sensação dolorosa. A PA e FC foram avaliadas através de esfingnomanômetro com coluna de mercúrio, também em dois momentos; inicialmente, com o paciente na sala de espera e, imediatamente aotérmino do atendimento, com o objetivo de correlacionar o controle eficaz da dor com a variação dos parâmetros cardiovasculares avaliados. De acordo com os resultados obtidos concluímos que a dor e a ansiedade não foram capazes de alterar significativamente a pressão arterial e freqüência cardíaca.