Allergic reactions to lignocaine.

True allergic reactions to local analgesics are extremely rare. This case report illustrates the procedures adopted to manage a patient with a history of suspected allergy. A young woman was found to have a true type I hypersensitivity to lignocaine. Another routinely used local analgesic agent, prilocaine, was tested by the same methods and found to give no allergic response. Dental treatment was successfully completed using the latter and the patient advised to wear a medical alert bracelet.

Balancing the extraction of primary teeth: a review.

Balancing the extraction of primary teeth is a procedure advocated to maintain symmetry of the developing dentition by encouraging symmetrical drift of teeth mesial and distal to the extraction sites on each side of the dental arch. Current opinion about this procedure expressed in standard reference works is confused and occasionally contradictory. Whilst some authorities cite specific situations where balancing extractions should be performed, others are less precise with their advice, and at least one considers that there is little justification for the procedure. Scientific evidence supporting the procedure is tenuous. The one study carried out specifically to compare dental centre line shift following unilateral or bilateral extraction of primary teeth showed greater shift in cases of unilateral (unbalanced) extractions. Other studies do not directly address the issue and such information as they offer is imprecise. Although the procedure of balancing extractions is strongly advocated by many clinicians, it is not based on definitive experimental evidence.

A clinical trial to evaluate the retention of a silver cermet-ionomer cement used as a fissure sealant.

A randomized clinical trial was under-taken to compare the retention of a silver cermet-ionomer cement, Ketac Silver, with a conventional, autopolymerizing BIS-GMA resin sealant, Delton, using matched pairs of fissure sites within each subject's mouth. One hundred twenty matched contralateral pairs of fissure sites in first and second permanent molars of 53 school children were sealed with the two materials. The choice of site and material was selected at random. The ages of the children ranged from five to 16 years; first permanent molars were sealed in the five- to 10-year age group, and second permanent molars in the 11- to 16-year age group. Sealants were assessed as present, partly present, or absent at 6, 12, and 24 months. The number of pairs of sites available for reassessment declined from 102 at six months to 59 at 24 months as patients were lost to the study. Retention rates were higher for the Ketac Silver sealants at all three inspection intervals (P < 0.01): 93% compared with 74% at six months, 81% compared with 65% at 12 months, and 83% compared with 58% at 24 months. When analyzed according to age range, the difference between the retention rates was statistically significant in the five- to 10-year-olds but not significant in the 11- to 16-year-olds. The conclusion reached in this study was that cermet cement was better retained than conventional resin sealants in younger children.

Root agenesis in developing canines as a complication of intranasal antrostomy.

A case is reported in which the roots of both maxillary canines failed to develop, a defect that could be traced to antral surgery when the patient was 8 years of age. The differential diagnosis of such a finding is proffered. The maxillary antrum is described, and aspects of the surgical procedure, the nasal antrostomy, used in this patient are discussed. A brief outline of current thought on the mechanisms of eruption of teeth is appropriate, and treatment of the symptomatic tooth is mentioned.