Local anesthetics allergy in children: Evaluation of diagnostic tests with Real-Life data.

BACKGROUND: Local anesthetic (LA) drugs are commonly used in clinical practice to provide effective analgesia, including in dentistry and minor surgical procedures. The perception of a high risk of allergy in daily applications leads to the referral of atopic patients and those with other drug allergies to allergy clinics for the evaluation of allergic reactions to LA. The aim of this study was to determine who should be referred to the allergy clinic for LA allergy testing, assess the frequency of LA allergy in pediatric patients, and identify the negative predictive value of skin tests in diagnosis. METHODS: January 2017-July 2023, the clinical and laboratory data, as well as the results of drug allergy tests, of patients referred to our pediatric allergy clinic by dentists and physicians performing minor surgical procedures with suspected LA allergy were retrospectively evaluated. RESULTS: Our study included a total of 153 patients, comprising 84 girls (54.9%) and 69 boys (45.1%), with a mean age of 8.9 (±3.3) years. The most common reason for referral was a history of non-LA drug allergies (n = 66, 43.2%), followed by asthma (n = 25, 16.3%). Hypersensitivity reactions (HRs) with LA were most commonly associated with articaine (n = 7, 4.8%), followed by lidocaine (n = 6, 4.1%). When intradermal tests were evaluated, 17 patients (11.1%) had a positive test result. The positivity for lidocaine was 70.6% (n = 12), and prilocaine was 29.4% (n = 5). Subcutaneous provocation was administered to 109 patients (71.2%), and one patient exhibited local erythema and swelling with prilocaine. CONCLUSION: Although LA allergy is a rare occurrence, consultations of this nature are frequently requested from allergy clinics in real life. Considering the negative predictive value of skin tests performed with LA drugs, the reaction rate appears to be low in patients with atopy or other drug allergies. It is crucial for all relevant healthcare professionals to be knowledgeable about the appropriate approach to suspected LA allergies to avoid unnecessary tests. To the best of our knowledge, our study is the most comprehensive work in the literature that evaluates the results of diagnostic tests in children referred with a suspicion of LA allergy.

Treatment of hydatid cyst with albendazole desensitization: A pediatric case report.

Albendazole is a benzimidazole group drug used alone or in combination with surgery in the treatment of many helminthiasis, especially hydatid cysts. Type 1 hypersensitivity reaction has been reported rarely. Treatment with desensitization has been successfully applied in a few adult patients, however literature information on pediatric patients was not available. Here, we present a pediatric case in which Type 1 reaction occurred due to the use of albendazole during hydatid cyst treatment and undergone desensitization.

Evaluation of fracture resistance of inlay-retained fixed partial dentures fabricated with different monolithic zirconia materials.

STATEMENT OF PROBLEM: Data are lacking on the fracture resistance of monolithic zirconia inlay-retained fixed partial dentures as a conservative treatment for a single missing tooth. PURPOSE: The purpose of this in vitro study was to evaluate the fracture resistance of inlay-retained fixed partial dentures produced from 3 different monolithic zirconia materials and based on 2 preparation types and applications with and without thermocycling. MATERIAL AND METHODS: A model with missing right and left mandibular first molars was used for different cavity preparations. A tube-shaped cavity and a box-shaped cavity were prepared. Seventy-two epoxy resin casts were prepared from an additional silicone impression. Twenty-four inlay-retained fixed partial dentures from each monolithic zirconia material (Prettau, Zirkonzahn; Katana, Noritake; and Copran, Whitepeaks) were fabricated for each preparation type and cemented to their epoxy model with dual-polymerizing adhesive resin cement; 50% of all specimens were thermocycled for 10000 cycles. The specimens were subjected to a fracture resistance test using a universal testing machine with a crosshead speed of 0.5 mm/min. Fracture surfaces were examined with scanning electron microscopy (SEM), and a specimen from each group was examined for structural changes with differential thermal analysis (DTA). RESULTS: No statistically significant differences in terms of fracture resistance were found among brands with both cavity designs and with and without thermal cycles (P>.05). However, SEM and DTA results showed some changes in monolithic zirconia structure after 1 year of aging. CONCLUSIONS: The brands and cavity preparation types for single posterior tooth loss generated similar fracture resistance.

Evaluation of marginal and internal adaptation of hybrid and nanoceramic systems with microcomputed tomography: An in vitro study.

STATEMENT OF PROBLEM: The accuracy of recently introduced chairside computer-aided design and computer-aided manufacturing (CAD-CAM) blocks is not well established, and marginal integrity and internal adaptation are not known. PURPOSE: The purpose of this in vitro study was to evaluate the marginal and internal adaptation of hybrid and nanoceramics using microcomputed tomography (µ-CT). MATERIAL AND METHODS: The marginal and internal adaptation of 3 polymer-infiltrated ceramic-network (PICN) materials (Vita Enamic [VE]; Lava Ultimate [LU]; Vita Suprinity [VS]) were compared with lithium disilicate (IPS e.max.CAD, IPS). Ninety-six specimens (48 dies and 48 crowns) were prepared (n=12 each group) using a chairside CAD-CAM system. The restorations were scanned with µ-CT, with 160 measurements made for each crown, and used in 2-dimensional (2D) analysis. The marginal adaptation of marginal discrepancy (MD), absolute marginal discrepancy (AMD), internal adaptation of shoulder area (SA), axial space (AS), and occlusal space (OS) were compared using appropriate statistical analysis methods (α=.05). Cement volumes were compared using 3D analysis. RESULTS: The IPS blocks showed higher MD (130 µm), AMD (156 µm), SA (111 µm) (P<.05), AS (52 µm), and OS (192 µm) than the other blocks (P<.01). The adaptation values of VS were significantly lower than those of the IPS block (P<.05). The adaption values of the LU and VE blocks were significantly lower than those of others (P<.01) but were statistically similar to one another (P>.05). IPS had the largest cement space at 18 mm3 (P<.01). CONCLUSIONS: The marginal and internal adaptation values were within a clinically acceptable range for all 3 hybrids and nanoceramics tested.

The effects of ethanol on insulin-like growth factor-I immunoreactive neurons in the central nervous system.

OBJECTIVE: To evaluate the effect of chronically ethanol treatment on insulin-like growth factor-I (IGF-I) synthesis in various adult brain regions using immunocytochemistry. METHODS: We performed this study at the Faculty of Medicine, Kocaeli University, Kocaeli, Turkey from March 2006 to October 2007. The vascular perfusion was utilized to fix the adult rat brains (10 for each group). After applying the routine histological techniques, the tissues were embedded in the paraffin. The immunohistochemical protocol was applied to the 10 um thick sections and the expression of IGF-I positive cells were observed in the neuro-anatomic areas. RESULTS: The distribution of IGF-I immunoreactive cells differed between the layers of the normal cerebral cortex and in the thalamic areas. In the alcoholic brain, the amount of IGF-I immunoreactive cells were decreased compared to the similar neuro-anatomical areas examined in the normal brains. CONCLUSION: The presence of IGF-I immunoreactivity in the neurons of the various neuro-anatomic areas demonstrates clearly that, these particular neurons are active in IGF-I synthesis. The decrease in the immunoreactivity of IGF-I in the chronically ethanol treated adult rat brain areas, show clearly that, ethanol effects negatively on the IGF-I synthesis.