The Journal of the American Dental Association
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Intravenous diazepam is an excellent anxiolytic drug for dental patients. Thrombophlebitis associated with its use has prompted this review. Recognition and management of thrombophlebitis are discussed along with the causes of vascular injury after intravenous diazepam. ⋯ The reviewed methods of minimizing thrombophlebitis after intravenous diazepam are with hepari flush or saline solution flush, steroids, vein size and venipuncture site, the use of a different vehicle, dilutions, and the use of other benzodiazepines. Lorazepam, midazolam, and flunitrazepam are relatively new benzodiazepines that produce less thrombophlebitis than diazepam after injection. These newer benzodiazepines are still being investigated and more clinical trials must be done to recommend any of them as alternatives to intravenous diazepam in dentistry.
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Nine cases of sexual phenomena that occurred with use of nitrous oxide and oxygen sedation are described. Dentists involved routinely used concentrations of nitrous oxide greater than 50% and did not have assistants in the room during dental procedures. Recommendations on the concentrations of nitrous oxide and the presence of an assistant are made.
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A case of a 14-year-old black girl with a lesion that appeared to be a dentigerous cyst is presented. Radiographic appearance, findings of a bone scan and biopsy by aspiration are discussed. Histologic findings showed that the lesion was an ameloblastoma that is believed to have arisen from the dentigerous cyst wall.
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Relaxation and distraction techniques designed to reduce stress during operative dental procedures were evaluated with a number of different measures. The results indicate that both techniques can be effective in alleviating anxiety and reducing stress. Some findings suggested that relaxation was more effective with women than with men whereas distraction may be more effective with men than with women. Further research is needed to refine these techniques that should be readily adaptable to dental practice.