Journal of endodontics
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Journal of endodontics · Jun 2014
Randomized Controlled Trial Comparative StudyEfficacy of articaine versus lidocaine as a supplemental buccal infiltration in mandibular molars with irreversible pulpitis: a prospective, randomized, double-blind study.
Profound pulpal anesthesia in mandibular molars with irreversible pulpitis (IP) is often difficult to obtain and often requires supplemental injections after an ineffective inferior alveolar nerve block (IANB). The purpose of this prospective, randomized, double-blind study was to compare the efficacy of 4% articaine with 2% lidocaine for supplemental buccal infiltrations (BIs) after an ineffective IANB in mandibular molars with IP. In addition, the use of articaine for IANB and intraosseous injections was investigated. ⋯ Supplemental BI with articaine was significantly more effective than lidocaine. The IANB success rate of 4% articaine confirmed published data.
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Journal of endodontics · Jun 2014
Review Case ReportsOrbital, mediastinal, and cervicofacial subcutaneous emphysema after endodontic retreatment of a mandibular premolar: a case report.
Subcutaneous emphysema (SCE) rarely occurs from endodontic treatment. Most reported cases of iatrogenic SCE occur in the cervicofacial region. Only a few cases have been reported of SCE extending into the mediastinum or orbital spaces. In the present report, we describe a concomitant occurrence of orbital, mediastinal, and cervicofacial SCE immediately after endodontic retreatment. ⋯ SCE may go undetected or misdiagnosed. Complications may be fatal. Therefore, clinicians should apply preventive measures and know how to identify and manage SCE. We review reports of SCE in the last century, discuss etiology and differential diagnosis, and present recommendations for prevention and management of SCE.