A Randomized Control Trial Comparing Buccal Infiltration of 4% Articaine with Buccal and Palatal Infiltration of 2% Lignocaine for the Extraction of Maxillary Premolar Teeth.

INTRODUCTION: The use of articaine has been claimed to obviate the need for routine palatal local anesthetic injections on account of its better diffusion through soft and hard tissues as compared to other local anesthetic agents. OBJECTIVE: The objective of the study is to evaluate the efficacy of 4% articaine (with 1:100,000 adrenaline) infiltrated only buccally in the extraction of maxillary premolars for orthodontic reasons. MATERIALS AND METHODS: A double-blind randomized clinical trial with a split-mouth design, where each patient (n = 100) was part of two groups, was conducted. Experimental Group 1: single buccal infiltration of 4% articaine with 1:100,000 adrenaline (Septanest™ with adrenaline 1:100,000 by Septodont). Control Group 2: routine buccal and palatal infiltrations of 2% lignocaine with 1:200,000 adrenaline (Lox™ 2% with adrenaline 1:200,000 by Neon). The parameters studied were time to onset of anesthesia, pain during the extraction procedure (not during the injecting of the local anesthetic), and frequency of extra amount of local anesthetic injected. RESULTS: The difference was not statistically significant (P > 0.05) between the two groups with respect to all three parameters. This proves that a single buccal infiltration of articaine can be used as an alternative to lignocaine for the extraction of the maxillary premolar teeth in most of the cases. CONCLUSION: This proves that a single buccal infiltration of articaine can be used as an alternative to lignocaine for the extraction of the maxillary premolar teeth in most of the cases.

To determine the efficacy of ultrasonography in the evaluation of bone fill at the regenerate site for mandibular distraction osteogenesis over clinical and radiographic assessment- An in vivo prospective study.

Until date conventional radiographs and computed tomography are the preferred diagnostic modalities to monitor the distraction osteogenesis regenerate. But these techniques do not detect the ongoing osteogenic process; moreover they obligate the patient to serial radiation exposure. In addition, anatomic overlap and metal artifacts obscure the virtual findings. In contrast, ultrasound is a noninvasive, efficient and an inexpensive way to evaluate bone healing. This study was conducted to test the efficacy of ultrasound in evaluating bone healing at the mandibular distraction site. Twenty patients underwent mandibular distraction. The wounds were assessed with an orthopantomograph and an ultrasound at the end of latency, mid distraction, end of distraction and post distraction periods i.e. 6 weeks, 8 weeks and 4months. Estimates of bone formation, using a semiquantitative radiological, ultrasonographic and intraoperative surgical bone fill scores were made. The correlation between intraoperative and ultrasonographic bone fill scores was statistically significant at 0.602, a total of 26 of the 31 sites correlated. Corresponding correlation between intraoperative and radiographic bone fill scores was 0.332, and only 13 of the 31 sites correlated. The results indicate that ultrasound is potentially an accurate noninvasive technique that is most useful in assessing the mandibular distraction regenerate.

Melanotic neuroectodermal tumour of infancy - A rare entity.

Melanotic neuroectodermal tumour of infancy (MNTI) is rare, rapidly growing, pigmented neoplasm of neural crest origin. It is generally accepted as a benign tumour despite of its rapid and locally destructive growth. It primarily affects the maxilla of infants during the first year of life. Surgical excision is considered as the treatment of choice. The recurrence rate varies between 10% and 15%, and malignant behaviour has been reported in 6.5% of cases. We report a case of MNTI, associated with an erupted primary tooth in a 5-month-old male child. We discuss the clinical, radiographic and histologic features of this rare tumour, as well as its surgical management and the follow-up.

Management of a mucocoele of the submandibular gland without removal of the gland: a case report.

A mucocoele or extravasation of mucus is common in minor salivary glands, but unusual in major ones. Those from the submandibular gland are a diagnostic challenge and conventional management includes excision of the associated gland. We describe a 27-year-old man with a mucocoele of the submandibular gland that presented as a lateral cervical swelling and looked like a plunging ranula. The cystic lesion was completely excised and, to our knowledge, this is the first published case in which the submandibular gland was saved with no recurrence up to two years postoperatively.