Post-tonsillectomy infiltration with bupivacaine reduces immediate postoperative pain in children.

Pain management after tonsillectomy in children remains a dilemma for the anaesthetist. A previous study demonstrated that the administration of lidocaine 1% topical spray to the peritonsillar fossae before tracheal extubation provided considerable immediate postoperative pain relief in infants and children. However, the pain relief was of short duration. We were hopeful that the use of bupivacaine would offer more prolonged pain relief because of its pharmacological characteristics. Therefore, this study was designed to compare the effects of bupivacaine 0.5% with 1:200,000 epinephrine administered after tonsillectomy either as topical spray or submucosal infiltration on postoperative pain in children. Forty-three patients aged two to ten years were randomized into three groups after tonsillectomy was performed. Group (1) received 0.5 ml.kg-1 normal saline spray; (2) received 2 mg.kg-1 bupivacaine 0.5% with 1:200,000 epinephrine peritonsillar infiltration in a similar volume to Group 1 and; (3) received 2 mg.kg-1 bupivacaine 0.5% with 1:200,000 epinephrine spray to both tonsillar beds. The patients in each group were compared postoperatively with regard to the quality of pain control using the Objective Pain Score, and their analgesic requirements. Peritonsillar infiltration of bupivacaine provided superior immediate postoperative analgesia as reflected by lower recovery room pain scores (P < 0.05) and opioid requirements (P < 0.01). Ward pain scores and analgesic requirements were similar among groups. Peritonsillar infiltration of bupivacaine 0.5% with 1:200,000 epinephrine provides better post-tonsillectomy pain control in the immediate postoperative period than bupivacaine spray or placebo.

Oral health status and treatment needs of an insured elderly population.

The purpose of this study was to describe the oral health status and treatment needs of an elderly group of religious sisters whose dental care expenses had been covered for most of their adult life. While the residents displayed high levels of treated dental disease on examination, evidence of a need for further treatment was considered to be a reflection of their decreasing ability to manage their personal home care and the reduction in professional services available to them. The results of this study reinforce the notion that the continuous provision of preventive and educational strategies coupled with accessible treatment services are essential, especially in an aging population.

Amalcore strength recovery following refilling of access preparations with amalgam.

After endodontic treatment through an amalgam core, the recommended procedure is to replace the entire core. This study examined the strength achieved by restoring the access openings with dental amalgam and reported the type of failure during strength testing. Seventy-two Dispersalloy 8 x 8 mm cylindrical specimens were produced using controlled condensation pressures. The specimens were randomized in three groups: (1) controls, (2) 3 mm access preparations wetted with mercury-rich amalgam before restoration, and (3) 3 mm access preparations restored unwetted. The specimens tested for compressive strength were separated in two subsets. The unwetted group demonstrated significantly less strength than the control and wetted group (p less than 0.05), while the unwetted and wetted groups revealed significantly less strength than the control group (p less than 0.05). The mean diametral tensile strength recovery for the wetted and unwetted groups was 76% and 69%, respectively. The qualitative assessment of the fracture zones indicated that wetted specimens exhibited more fractures through the new amalgam core than the unwetted specimens (p less than 0.05). It would appear that amalgam refilling of access preparations through amalgam cores has clinical potential.

The issues of chemical dependency in dentistry.

The problem of chemical dependency is a topical issue in society today. With the increase in the number and types of prescription drugs, the proliferation of illegal drugs, and easy access to alcohol, chemical dependency has no socioeconomic boundaries. Professionals, blue collar workers and students, both male and female, are susceptible to the problem. The purpose of this paper is to review the literature on chemical dependency as it relates to the profession of dentistry. It will also look at the definition, prevalence, etiology, recognition, treatment and prevention of chemical dependency. Most of the evidence from the literature indicates that chemical dependency is a disease; it is treatable and can be prevented. The treatment of the disease requires the input of support groups at the professional level as well as at student level. The prevention of chemical dependency must begin in the curricula of dental schools with emphasis on the pharmacology and interaction of drugs.

A versatile soil percolator.

A simple multiple column soil percolator is described. Individual columns operate in parallel and are independent. The apparatus may be operated by pressure or suction. An experiment on the effects of pesticides on nitrification in the percolator is described.