Limitations of rotational panoramic radiographs in the diagnosis of maxillary lesions. Case report.

This case report clearly demonstrates that misdiagnosis may result from failure to recognize the limitations dictated by the width of the focal trough in rotational panoramic radiographs. The patient's clinical signs and symptoms were at variance with the findings from the rotational panoramic radiograph. A subsequent radiographic view by the occipito-mental (Water's) projection showed the extent and malignant features of the lesion.

The teaching of dento-maxillo-facial radiology in Australian dental schools.

The skills necessary to successfully perform radiological procedures in general dental practice are described and should be used as criteria when developing an effective undergraduate curriculum and as determinants of the contents of continuing education programmes. The present status of undergraduate curricula. continuing education, and postgraduate programmes as well as the recognition of the specialized nature of dento-maxillo-facial radiology, are discussed and recommendations for future developments are made.

Cardiovascular responses to intraosseous injections of prilocaine containing vasoconstrictors.

A study of the cardiovascular responses to prilocaine hydrochloride (Citanest) given by intraosseous injection showed that there were no effects related to the absorption of this anesthetic. The presence of epinephrine in concentrations of 1:2000,000 was detected by its rapid absorption and stimulation of the heart rate. The injection of octapressin with prilocaine hydrochloride was usually accompanied by no heart rate or blood pressure changes. However, the heart rate decreased slightly in a few subjects, and this slower heart rate returned to preinjection values within 5 minutes.

Cardiovascular responses to intraosseous injections containing catecholamines.

The cardiovascular responses to Adrenaline and Noradrenalin, given intraosseously, are reported. Intraosseous injections of anesthetic containing catecholamines clearly demonstrate the rapidity with which the catecholamines are absorbed into the general circulation. Adrenalin-containing local anesthetic gave rise to rapid increases in the heart rate and blood pressure within a few seconds of the injection. Such cardiovascular responses, in many instances, were unacceptable to the subject because of the tachycardia and a feeling of intense tightness across the thorax. With Noradrenalin, on the other hand, the cardiovascular responses were asymptomatic, although it was usual for the heart rate to fall while the peripheral resistance and the blood pressure increased. Direct comparison was made, in the same persons, of infiltration and intraosseous injection of a Noradrenalin-containing local anesthetic. Insignificant responses were found with infiltration injections of catecholamines (0.9 ml. of 1/80,000 solutions) which is in agreement with previously published data. However, similar solutions injected intraosseously elicited cardiovascular responses. Although intraosseous injection of lidocaine hydrochloride containing 1/80,000 Noradrenalin appears clinically acceptable, a further search for anesthetics without effects on the cardiovascular system is desirable.

Comparative circulatory effects of adrenaline and noradrenaline during intra-osseous dental anaesthesia.

The effects of intra-osseous dental anaesthesia on heart rate and blood pressure was examined in 17 healthy volunteers. Adrenaline containing anaesthetic solutions were accompanied by increased heart rate and elevated systolic blood pressure which were not acceptable to a high proportion of subjects. Noradrenaline at the same concentration as adrenaline (1/80 000) usually decreased the heart rate and elevated the blood pressure. A few subjects experienced a feeling of weakness in the lower extremities when noradrenaline was injected. Endogenous catecholamine formation in these test conditions gave rise to insignificant circulatory effects.

Minimizing radiation exposure in dental radiology.

Rectangular field collimation gives high quality roentgenograms and reduces unnecessary exposure of radiation to the patient by 73-96 per cent.