Journal - Canadian Dental Association = Journal de l'Association dentaire canadienne
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A young female patient is referred to the oral surgery clinic to ligate an impacted upper canine. Shortly following injection, whitening of the skin is noted. The physiopathology is explained according to different hypothesis. The use of different types of syringes is also discussed.
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Comparative Study
A comparison of the effectiveness of nitrous oxide scavenging devices.
Four nitrous oxide scavenging systems were tested for their efficiency under ideal standardized conditions. The volunteers received 35% nitrous oxide for 20 minutes and the levels of nitrous oxide recorded and averaged every five minutes. No density was carried out. ⋯ To do so under normal dental operating conditions provides many variables, such as the type of procedure carried out, movement by the patient, ventilation efficiency of the operatory, type of mouth pack utilized etc. This investigation was therefore designed to eliminate all operator and procedure variabilities. Each system was evaluated under ideal identical conditions and with no actual treatment being carried out.
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Five scavenging systems were installed in 10 dental office and the levels of nitrous oxide were closely monitored for each. While the readings were higher than the previous non-clinical study, all appeared to be reasonably efficient. The various factors which caused increases in background levels were also recorded in the investigation.
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A recent publication discussing the concern with nitrous oxide pollution in dental offices and the methods available to reduce this risk aroused interest in scavenging systems. This is the first in a series of three articles and will explain the mechanisms of the nitrous oxide systems available. The second describes the testing of these systems under ideal conditions and the third will assess their efficiency in various dental offices and the factors which were found to detract from that efficiency.
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Over the past decade, an array of monitoring devices have been developed to continuously assess patient oxygenation. While actual tissue oxygenation is the most desirable measurement, the pulse oximeter offers a non-invasive method of measuring oxygenation of arterial blood. In this study, the arterial oxygen saturation (SaO2) of children presenting for oral surgical procedures under general anesthesia was continuously monitored. ⋯ This study showed that 22.5 per cent of children significantly desaturated (SaO2 less than 90 per cent) during this period - a figure which is in complete agreement with several similar studies done recently. This desaturation preceded not only hemodynamic changes, but frequently changes in tissue and blood colour as well. The authors conclude that children should receive supplemental oxygen in the immediate recovery phase following general anesthesia.