Local Anesthetic Used for Dental Treatment in Children- Systematic Review.

Aims: To analyse the existing literature on the effectiveness of various injectable amide local anaesthetic agents for children undergoing routine dental treatment. Design: A systematic search was carried out for the databases of PubMed, Central, LILACS, Science direct, Metapress and SIGLE to identify clinical trials published on the effectiveness of injectable amide local anaesthetic agents in dental journals from the inception of the databases up to July 2015. Results: The systematic search gave nine studies. Four of out seven studies found articaine to more effective. No significant difference in anaesthetic effectiveness of the agents were found in seven studies. One study reported significant difference in the anaesthetic effectiveness in favour to articaine. Two studies reported articaine to have longer duration of action. Conclusion: With the available evidence, this review may suggest that articaine is an effective amide anesthetic agent. Lignocaine is most effective at 2% concentration. Prilocaine and mepivacaine show comparable effectiveness. As eight of the studies have high risk of bias, there is a greater need for well-designed randomized controlled studies to be conducted to assess effectiveness of various injectable amide local anaesthetics to be used in children for routine dental treatment.

Alopecia areata of dental origin in a child.

Alopecia areata (AA) is a chronic inflammatory disease that involves the hair follicle. Current evidence indicates that hair follicle inflammation in AA is caused by a T-cell-mediated autoimmune mechanism occurring in genetically predisposed individuals. AA has a reported incidence of 0.1%-0.2%, with a lifetime risk of 1.7%. It has also been found that AA accounts for roughly 2% of new dermatology outpatient cases in the US and the UK, 3.8% of cases in China and 6.7% of cases in Kuwait. Pediatric AA constitutes approximately 20% of all AA cases. AA affects males and females equally. The most common site to be affected is the scalp (90%). The face, eyebrows, eyelashes, beard, underarm hair, and pubic hair may be affected and, sometimes, even the entire body. AA requires combined therapy, involving topical or intralesional corticosteroids, immune therapy with diphenylcyclopropenone, and even psychotherapy. In some cases, treatment consists of simply eliminating the dental infectious process. This case report describes AA of dental origin in a 9-year-old girl, which resolved after management of the dental problem.