The British journal of oral & maxillofacial surgery
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Br J Oral Maxillofac Surg · Jul 2012
Randomized Controlled Trial Comparative StudyEfficacy of liposome-encapsulated 0.5% ropivacaine in maxillary dental anaesthesia.
The aim of this study was to evaluate the effectiveness of liposome-encapsulated ropivacaine (0.5%) in dental anaesthesia. This randomised, double-blind, crossover, four-period treatment study included 40 volunteers who were given 1.8 ml of the following local anaesthetics into the buccal sulcus at the right level of the upper canine: 0.5% ropivacaine; 0.5% ropivacaine with 1:200,000 adrenaline; liposome-encapsulated 0.5% ropivacaine; and 2% lignocaine with 1:100,000 adrenaline. Onset of pulpal anaesthesia; the success of anaesthesia; and the duration of labial, gingival, and pulpal anaesthesia involving the upper right canine and first premolar were evaluated. ⋯ Ropivacaine and adrenaline and lignocaine and adrenaline gave a significantly longer duration of pulpal anaesthesia. VAS showed no significant differences among the groups tested. The results showed that encapsulation of liposome did not improve the anaesthetic efficacy of ropivacaine.
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Br J Oral Maxillofac Surg · Jul 2012
ReviewLitigation in National Health Service oral and maxillofacial surgery: review of the last 15 years.
Litigation claims are increasing in medicine but we know of little detailed analysis of those published concerning oral and maxillofacial surgery (OMFS) despite information being freely available from the NHS Litigation Authority (NHSLA) under the Freedom of Information Act. We obtained information from the NHSLA on clinical and non-clinical negligence claims in OMFS from April 1995 to August 2010, and analysed the data with outcomes and a further breakdown of subspecialty. During the period 318 claims relating to OMFS were registered. ⋯ The total amount paid out was in excess of £5 million, and the highest claim (more than £300,000) during the period was for misdiagnosis of an oral cancer. Litigation in OMFS is increasing, as is the number of cases that necessitate compensation by the NHSLA. We discuss the trends and implications.