ABSTRACT
Trigemino-cardiac reflex is occurrence of hypotension and bradycardia upon surgical manipulation of areas supplied by the trigeminal nerve, and has been reported during craniofacial maxillofacial and ocular surgeries. Communication between the anaesthetic and surgical team is essential, and cessation of the precipitating stimulus is the first and most important therapeutic step. We report a case of immediate, reproducible, and reflexive response of Bradycardia and dysrhythmia upon manipulation of orbital fracture during orbital floor reconstruction in a 65-year-old man. Upon recognition of the reproducible relationship between falcine stimulation and increased vagal tone, the patient was given atropine in an effort to block cholinergic hyperactivity. After atropine administration, no further dysrhythmias occurred and surgery was carried uneventfully.
ABSTRACT
Dens evaginatus is a disturbance in tooth development that produces a tubercle of hard tissue on the surface of the tooth. While prophylactic pulp capping is recommended for vital teeth, teeth with necrotic pulps require endodontic therapy or extraction. This rare case of a 24-yr-old Indian male with affected maxillary central incisors demonstrates the clinical consequences of dens evaginatus.
