ABSTRACT
Background: Ropivacaine have not been used frequently in conjunction with conscious sedation to provide regional block for dentoalveolar surgical procedures. This study was designed to compare the clinical efficacy of Ropivacaine with that of the commercially available Bupivacaine. The current study was conducted to compare these techniques for intraoperative cardiopulmonary stability, patient cooperation, comfort, recovery time, and postoperative nausea and vomiting
Methods: 60 ASA grade I-II patients undergoing lower third molar odontectomies under conscious sedation based regional block, were recruited and randomized to receive Ropivacaine 5 mg ml[1], or bupivacaine 5 mg ml[1]. Sedation was titrated to accomplish a level of sedation in which the eyes were closed and the patients were responsive to verbal commands. Subjects were monitored for variability of heart rate, blood pressure, oxygen saturation, comfort, cooperation, nausea and vomiting. Patients were interviewed at 24 h and at 3 days to identify any residual problems. .Pain was measured on injection, during surgery and during suturing, using Visual Analogue Scale [VAS]
Results: All blocks were adequate for the proposed surgery, but there were significant differences between the two groups in mean time to onset of sensory block [Ropivacaine 7 min bupivacaine 5 min: <0.005], and mean duration of sensory block [Ropivacaine 56.5 min; bupivacaine 118 min; =0.001]. No patients in both groups required treatment for hypotension and no adverse reaction were noted
Conclusions: Ropivacaine provides reliable regional block of shorter duration than bupivacaine. No other differences were noted as regard pain on injection, quality of block but the recovery profile for ropivacaine may be of interest given that more surgery is being performed in the day-case setting
ABSTRACT
Mandibular overdentures supported by two endosteal implants has become a valid treatment altenative. However, selecting the best implants site is still unclear
Aim of the Study: This study aimed to evaluate the effect of implant site selection on marginal bone loss and bone density around immediately loaded implants supporting mandibular overdentures
Materials and Methods: Sixteen root form endosteal implants were installed in four completely edentulous patients in the interforaminal region. The implants were installed according to the one stage immediate loading protocol to support mandibular overdentures. The implants were divided into two groups: Anterior Group: Implants installed in the area of the lower lateral incisors. Posterior Group: Implants installed in the area of the lower first premolars. All patients were followed up clinically and radiographically for one year. Direct digital radiography was utilized to evaluate both marginal bone height and boric density in relation to both groups. Recorded data was statistically analyzed
Results: All implants osseointegrated successfully. Marginal bone height showed a continuous decrease throughout the follow up period. A statistically significant decrease in marginal bone height was recorded in the posterior group only at the 12 months follow up period. Bone density values showed a steady increase until the end of the follow up period. No statistically significant difference was found between the two groups regarding hone density measurements
Conclusions: The results of this study indicate that placing two implants supporting mandibular overdenture in the lower lateral areas rather than the lower premolar areas would have a favorable outcome on maintaining crestal hone height around the supporting implants
ABSTRACT
In patients with myofascial pain, painful trigger points are often treated using local anaesthetics and/or steroids injections. However, the therapeutic effects of these treatment have not been quantified, and the mechanism underlying the effect is poorly understood. In a randomized clinical trial, thirty adult patients of both sexes and of an age range of 17-42 years were treated for myofascial pain in the jaws. They had presented with myofascial pain that could be traced back to trigger points in the masseter and/or the temporalis muscles. The trigger point number and distribution was mapped prior to the commencement of any treatment form. The treatment results were analyzed after a series of local anaesthetic [xylocaine] injections only of the trigger points [group A], steroid [epidron] injections only [group B] and combined injection therapy [xylocaine + epidron] [group C. Data used for evaluation and statistical analysis included 1- number of trigger points before and after treatment sessions. 2- changes in pain measuring or visual analogue scale and 3-changes in maximal interincisal distance values. Electromyographic readings were used to monitor responses to different kinds of treatment. The results show group C patients to favour a significant and remarkable drop in the median number of trigger points after two weeks of therapy. Likewise, visual analogue scale ratings for group C patients decreased significantly after the second and third weeks of treatment. As for maximal interincisal distance values, they were markedly increased after the third week of treatment in the same group of patients