Journal of endodontics
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Journal of endodontics · Dec 2008
Randomized Controlled Trial Comparative StudyThe anesthetic efficacy of diphenhydramine and the combination diphenhydramine/lidocaine for the inferior alveolar nerve block.
The purpose of this prospective, randomized study was to compare the degree of pulpal anesthesia obtained in vital, asymptomatic teeth using 1.8 mL of 1% diphenhydramine with 1:100,000 epinephrine, 1.8 mL of 2% lidocaine with 1:100,000 epinephrine, and 3.6 mL of 2% lidocaine with 1:100,000 epinephrine combined with 1% diphenhydramine with 1:100,000 epinephrine in inferior alveolar nerve blocks. We also studied injection and postinjection pain. An electric pulp tester was used to test for anesthesia, in 4-minute cycles for 60 minutes, of the second molars through the central incisor. ⋯ The diphenhydramine solution was irritating on injection and postinjection and resulted in a very low level of anesthetic success. We concluded that a 1% diphenhydramine solution should be used cautiously for the inferior alveolar nerve block. The combination lidocaine/diphenhydramine solution was irritating postinjection and was not as effective as a lidocaine solution for pulpal anesthesia.
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Journal of endodontics · Dec 2008
Characteristics of accessory mental foramina observed on limited cone-beam computed tomography images.
In this retrospective study with limited cone-beam computed tomography (limited CBCT), we investigated the anatomic characteristics of the accessory mental foramina and accessory branches of the mandibular canal. The CBCT records of approximately 150 patients were evaluated, and 17 accessory mental foramina were found in 16 patients. The anatomic peculiarities of the mandibular canal that might be relevant to endodontic treatment were observed. ⋯ Verification of the existence of accessory mental foramina would prevent accessory nerve injury during periapical surgery. In root canal treatment, the possibility of accessory mental foramina-related nerve paresthesia seems low unless the mental foramen and mandibular canal are injured. Limited CBCT is effective for presurgical 3-dimensional assessment of the neurovascular structures in dentoalveolar treatment.