Diplopia temporária originada por anestesia dental: relato de caso músculo reto-lateral ipsilateral após a administração de anestesia local para a extração do. Please, help me to find this libros de anestesia en odontologia pdf. I'll be really very grateful. (PDF) Anestesia local en odontología. Local anesthesia, for example, can affect just a small patch of skin Manual de anestesia . individuals descargar Técnicas Anestesia Regional (Spanish Edition) epub. State Senator Jerry Hill has asked the Dental Board of.
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Epub Dec Numa primeira fase os voluntários foram sujeitos a anestesia infiltrativa periapical e numa segunda fase foi realizada. 2Faculty of Odonto-Stomatology, University of Health Sciences of Cambodia ( UHS), Cambodia. Results. The subjective and objective onset of action for the local anesthetics showed .. Berini-Aytes L, Gay-Escoda C. In: Anestesia Odontologica. ePub · References. Cited by Metrics. 6. Synapse/Crossref. Libro de Anestesia en Odontología de Carlos Macouzer Olivar Editoria: Manual Moderno Segunda Edición.
Therefore, we chose a 3-week interval between the surgeries in this study so that postoperative sequelae of the local anesthetic injection, such as pain and numbness, were reduced. These results are similar to those from the study by Rebolledo et al. However, the difference observed between the two anesthetic solutions was not statistically significant [ 11 ]. Many previous studies have confirmed that the onset of anesthesia for articaine was faster than that with lidocaine. In our study, the quicker onset of anesthesia with articaine than that with lidocaine, when the same concentrations of anesthetic and vasoconstrictor were used, was statistically significant. This difference in the two anesthetic solutions of the same concentration appears to be a more reliable comparison.
Comparative study of two needle models in terms of deflection during inferior alveolar nerve block.
Trigeminal nerve injury associated with injection of local anesthetics: needle lesion or neurotoxicity? Paresthesias in dentistry. Occurrence of paresthesia after dental local anesthetic administration in the United States. Erratum in: J Am Dent Assoc. Retrospective review of voluntary reports of nonsurgical paresthesia in dentistry. J Can Dent Assoc. Articaine hydrochloride: a study of the safety of a new amide local anesthetic. Madrid: Ergon; Necrosis of the skin of the chin: a possible complication of inferior alveolar nerve block injection.
The pulpal anesthetic efficacy of articaine versus lidocaine in dentistry: a meta-analysis. Buccal versus lingual articaine infiltration for mandibular tooth anaesthesia: a randomized controlled trial. Epub Mar Infiltration anesthesia for extraction of the mandibular molars. J Oral Maxillofac Surg.
Efficacy and complications associated with a modified inferior alveolar nerve block technique. A randomized, triple-blind clinical trial. Only the needle penetration sensitivity test showed sufficient sensitivity to reveal a difference in the anesthetic effect between EMLA and benzocaine.
Introduction Topical anesthesia is extremely important to a wide variety of dental procedures, such as periodontal probes, gingival manipulation, staple adaptation, preparation to infiltrative anesthesia, pediatric care, and traumatic lesions in the oral mucosa [ 1 — 3 ]. In this context, the main purpose of using topical anesthetic drugs is to reduce or relieve the painful stimulus caused by needle penetration, leading to significant control of pain and anxiety of the patient [ 1 ].
The ideal local anesthetic agent should be effective even when administered topically. However, not all anesthetic bases present this characteristic [ 4 ]. In dentistry, benzocaine is one of the main commercially available topical anesthetic drugs. It is chemically classified as an amino ester and is available as a gel.
Although this drug presents rapid onset of action, it has limited potency and short anesthetic duration, besides being exclusively used in mucous membranes [ 5 ]. This formulation is indicated for pain control in several superficial cutaneous procedures [ 6 , 7 ].
Accordingly, in the oral cavity, satisfactory results have been evidenced in biopsies [ 8 ], periodontal probes [ 9 ], and prior to local anesthesia [ 10 ]. Therefore, the aim of this study was to compare the effectiveness of the topical administration of benzocaine and EMLA on oral pain and tactile sensitivity.
Materials and Methods Twenty-four academics from the dentistry course of Dr. Three of these academics were excluded because they did not attend the second visit and another because of diabetes and incomplete medical records. Thus, the study continued with 20 volunteers, including 12 women and 8 men with an average age of The study was characterized as randomized, double-blind, split-mouth clinical trial.
The Research Ethics Committee of the Dr. Healthy subjects ASA I , meeting the criteria of the American Society of Anesthesiology ASA [ 11 ], were selected for this research, including nonpregnant, nonsmoker, nonnursing, with no history of allergies to local anesthetics, without chronic use of medications, with complete natural dentition and without reports of dysesthesia in the face or oral cavity. Participants who did not meet these criteria were excluded from the study.
Initially, we performed a molding of the maxillary arch of the participants, followed by the preparation of a model in plaster and acetate molding, with involvement of the teeth and palate. A relief area was created in wax and placed on the cast model on the palate, at 2 mm from the gingival margin, between the teeth 15 and 16 and 25 and 26, to create a reservoir for the local anesthetic drug Figure 1. They were instructed to keep their eyes closed and concentrate on the examination.
Figure 1: Acetate relief area for deposition of topical anesthetic drug. We applied 0. The sides of deposition of the topical anesthetic were randomly selected, by sorting a sealed envelope.
The mucosa was previously dried with gauze, and then the tray was positioned and maintained for 5 min. Figure 2: Acetate splint loaded with topical anesthetic. An examiner who was not present in the previous period was responsible for assessing the values related to the pain stimulus, which consisted of three quantitative sensory methods: superficial tactile perception, sensitivity to mechanical pain, and sensitivity to needle penetration.
The filaments were vertically applied at the predetermined points, in ascending order of diameter, until perception and identification of the stimulus by the participant. The filament in which the stimulus was perceived was recorded. Of note, three measurements were taken for each side.
The evaluated patient quantified the level of pain through the visual analogue pain scale [ 12 ] as previously described. Three measurements were taken for each side. The measurements started before the tray was applied and after contact with the topical anesthetic drugs at 5, 10, 20, and 30 min.
To perform comparisons in the same group, according to the time of contact with the topical anesthetic drug, the Friedman test was applied. All time points 5, 10, 20, and 30 min were assessed, and odds below 0. Results In the superficial tactile perception test, we observed a similar result between the side treated with EMLA and the side that was treated with benzocaine, represented by a decrease of tactile response to higher pressures in the oral mucosa in the five minutes time point, obtained with the use of thicker Semmes—Weinstein filaments Figure 3.
However, when comparing both groups EMLA versus benzocaine , no statistical repercussions were observed at the evaluated times Table 1. Figure 3: Median values for superficial tactile perception of benzocaine and EMLA according to the evaluated times and exerted force. Table 1: Intergroup comparative analysis according to the methodological test and value for each time point. When we compare each group singly, we observed that, at the five minutes point of measurement, there were statistically significant values in the decrease of superficial tactile perception when compared to the moment prior to the application of anesthetic agents.
These results were not statistically significant for the other times 10, 20, and 20 minutes Table 2. Table 2: Comparison in the same group according to the methodological test and value for each time point. The test of sensitivity to mechanical pain revealed that the patients presented minimal discomfort as attested by the analogue scale [ 12 ].
A comparative analysis between the treatments with the two drugs demonstrated a slight increase in the mechanical sensitivity in the benzocaine-treated side Figure 4 , at five minutes point. However, no statistical significant difference was observed at evaluated times, either in the intergroup analysis Table 1 or in an isolated group assessment Table 2. Figure 4: Median values for sensitivity to mechanical pain of benzocaine and EMLA treatments, according to the evaluated times and visual analogue scale VAS.
In the test of sensitivity to needle penetration, the benzocaine-treated side was more sensitive to the painful stimulus when compared to the EMLA-treated side, evidenced by higher visual analogue pain scores Figure 5.
In an intergroup analysis, we found a decrease in the pain sensitivity to needle penetration at 5 min and 10 min after the contact of the anesthetic drug with the oral mucosa Table 1 , with statistical relevance. When we evaluated each group separately, we observed that the side in contact with benzocaine had a statistical difference in point time of 30 minutes Table 2 , when compared to the time prior to contact with the topical anesthetic.
No other information with statistical relevance was observed for the other time evaluated and in the group treated with EMLA. Figure 5: Median values for sensitivity to needle penetration of benzocaine and EMLA treatments, according to the evaluated times and visual analogue scale VAS.
Discussion Dental anesthesia is among the main procedures associated with patient phobia in dental offices, leading a considerable number of adults to avoid dental treatments because of the fear of anesthetic puncture [ 13 ]. Nevertheless, patients with anxiety due to aversion to dental procedures usually report greater pain sensation during anesthesia than those who do not fear the anesthetic act [ 14 ]. Topical anesthesia has a main objective to annul pain prior to anesthetic infiltration [ 15 ].
This procedure optimizes infiltrative local anesthesia by reducing the level of anxiety of the patient before needle penetration, as well as decreasing the number of perforations required and the amount of anesthetic administered [ 2 ]. With the exception of the needle penetration sensitivity test, the other instruments of evaluation were not sensitive enough to show a statistical difference between EMLA and benzocaine, unlike other reports that revealed clearer results on the superiority of EMLA [ 10 , 16 ].
The influence of anesthetic bases on nociceptors and C fibers, both associated with pain stimuli, were evaluated by the tests of sensitivity to mechanical pain and needle penetration sensitivity. The first test was not sensitive enough to confirm statistical differences between EMLA and benzocaine in the two modalities of evaluation intergroups and isolated.
In our study, the VAS was used only to measure the intensity of pain. As observed in others reports [ 18 ]. In line with other studies [ 16 ], in the needle penetration sensitivity test, the side in contact with EMLA revealed less pain stimulation Figure 5. When we correlated the repercussions of the anesthetic effect over the evaluated times 5, 10, 20, and 30 min , statistically significant outcomes were obtained in the first 5 minutes and 10 minutes after contact with the topical anesthetic, when the needle penetration sensitivity test was applied Table 1.
These results support the evidence that local anesthetic drugs affect more the pain threshold than the sensory threshold [ 19 ]. Although we did not perform an evaluation of the time of action of the evaluated anesthetics, the main results with statistical relevance were present in the first 5 and 10 minutes of contact. This fact is corroborated by other studies that reveal duration of anesthetic effect over 20 minutes for EMLA [ 18 ]. To achieve a consistent evaluation of the topical anesthetic action, the methods of measurement should include not only the response to pain through the visual analogue scale, but also the influence on the somatosensory system, evaluated in this study by the superficial tactile perception and corroborated by other works that demonstrated favorable results for EMLA in the effectiveness of changing sensory and pain thresholds [ 20 ].
Thus, the use of Semmes—Weinstein needles and filaments in the measurement of the sensitive and painful responses in the present study were effective and simple to acquire and apply. Accordingly, earlier reports ratified the reliability and validation of these instruments for use in the oral cavity.
However, electronic measurements have showed greater precision in the results [ 18 , 20 ]. In fact, the unpleasant taste was one of the complaints of the participants, and the addition of flavor would facilitate their acceptance, especially in pediatric dentistry.