Evaluation of pain after administration of local anesthesia with and without medication [midazolam] in irreversible pulpitis in a sample of Sindh

The objective was to evaluate pain experience of the patient after administration of local anesthesia in symptomatic irreversible pulpitis with and without pre-medication Patients were diagnosed after taking medical and dental history, clinical examination, thermal tests and by taking radio-graphs. One hundred patients formed the study group. They were divided into two groups of fifty each, Group-A patients were given oral medication [Midazolan, Dormicum 7.5mg] and inferior dental nerve Block, while Group-B patients were given only Inferior Alveolar Nerve [IAN] Block [1.8 ml cartridge-1:100000 epinephrine] of Xylestesin-S [ESPE-Germany] without any pre-medication. Pre-operative pain of patients of both groups was recorded on Visual Analogue Scale [VAS] i.e: 0= no pain, 10 = most severe pain. [VAS 0>10] Group-A patients were given anesthesia 45 minutes after pre medication while Group-B, patients were treated routinely after administrating inferior dental nerve Block block. In group A [40% showed no pain, 44% mild pain, 12% moderate pain and 4% suffered severe pain n=50] while in group B [20% showed no pain, 50% mild pain, 20% moderate pain and 10% suffered from severe pain after the procedure was done. It was concluded that the patients who had received sedation, prior to anesthesia showed better results

Risk factors in spreading odontogenic infection

Spreading odontogenic infection is the extension of infection from its original site and can create potential life threatening situations. There are several risk factor reported for spreading odontogenic infection in literature including systemic health, virulence of organism and anatomical site. Apart from these factors odentogenic infection also observed in normal individuals. The objective of this study is to identify Risk factors in spreading odontogenic infection. Descriptive Case Series Study. This study was conducted in Department of Oral and Maxillofacial Surgery, Institute of Dentistry, LUMHS from January 2011 to February 2012. A descriptive case series study on 60 patients of spreading odontogenic infection was conducted. Male female ratio was 2.3:1, 2[nd] and 3[rd] decade was common presentation. The most frequent clinical findings were pain, swelling, trimus. The Buccal space was the most frequent location for a single space infection [53.3%], followed by Submandibular space [35%], Canine space [5%]. Three patients presented with multi space involvement [6.6%]. The most common involved tooth was mandibular third molar 26 [43.3%].The most common cause of the infection was periapical infection followed by pericronitis. 83.3% patient were healthy patients with no co morbid, only 16.7% patients were with co morbid like DM, hypertension and pregnancy. There was also no difference for mean WBC count. This study shows that lower molars were the most common involved teeth and buccal space was frequent space to be involved. The site of infection is important risk factors. We observed Odentognic infection in common in healthy individual than non-healthy individuals