Scandinavian journal of dental research
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Clinical Trial Controlled Clinical Trial
Conscious sedation by rectal administration of midazolam or midazolam plus ketamine as alternatives to general anesthesia for dental treatment of uncooperative children.
The trial included 24 children (aged 2-7 yr) referred for dental treatment under general anesthesia, since conventional behavioral management methods had failed to achieve treatment acceptance. As an alternative, they received, on two separate occasions with "identical" dental treatment, conscious sedation by rectal administration of either midazolam (0.3 mg/kg body weight (bwt)) or midazolam (0.3 mg/kg bwt) plus ketamine (1.0 mg/kg bwt). This allowed a double-blind, crossover design. ⋯ The combination also tended to be more efficient in relief of anxiety and prevention of pain, but there were large variations in the children's responses to the drugs. Midazolam significantly reduced the blood oxygen level, but not with ketamine added. For most children, both regimens proved to be appropriate as alternatives to general anesthesia.(ABSTRACT TRUNCATED AT 250 WORDS)
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A total of 142 women and 76 men with self-diagnosed oral galvanism who were referred from dentists and medical doctors for clinical evaluation during the last 2 yr are described from the perspective of general medicine. No case of clinically suspected mercury intoxication was found. Mean concentration of mercury in whole blood (B-Hg) was 17.3 nmol/l, and no value exceeded 50 nmol/l. ⋯ A total of 87 patients (40%) did not work because of medical reasons or unemployment. Amalgam removal was recommended in a total of 65 cases (29%), mainly on psychologic indications, but in 22 cases because of oral conditions. The clinical conditions behind the concept of oral galvanism seem to be explicable in terms of general medicine, and no generalized toxic effect of amalgam fillings need be suspected.
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This study measured the flexural and fatigue strengths of root canal posts of different alloy, design, and diameter. Fixed posts were loaded up to a preset force and the number of loadings endured until fracture was recorded at each loading force. The flexural strength was defined as the maximum force a post could endure before fracture when loaded once. ⋯ Aluminum posts had lower flexural and fatigue strengths than posts of titanium, stainless steel, and a Ag-Pd alloy, all of which had strength values of about the same magnitude. Among the investigated brands, Triax and Radix were stronger than the others at comparable diameters. The high strength of Triax may be explained by the design of the post, whereas a superior alloy may account for the high strength of Radix.
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Anevac-D, a new system for close scavenging of anesthetic gases in dental practice is described. It consists of a rubber nose mask surrounded by an outer rigid shell and a chin scavenger. A vacuum in the slot between the nose masks provides scavenging of gases escaping from the inner mask. ⋯ The average 4-min exposure varied between 90 and 250 ppm depending on system configuration and patient cooperation. Patient acceptance and clinical applicability were judged good. It is concluded that the Anevac-D system provides excellent scavenging properties and exposure levels well within the official recommendations by the Swedish Board of Occupational Safety and Health.
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Comparative Study
EMG versus force relationship in painful masseter muscles before and after intramuscular anesthetics and saline injections.
Electromyographic (EMG) activity of masseter and anterior temporal muscles, and bite force were analyzed in 28 young, fully dentate women with painful and tender masseter muscles before and after intramuscular injection of either lidocaine or saline in superficial masseter muscle. EMG-activity of the descending part of the trapezius muscle during increased bite force was also analyzed. ⋯ After saline injections no changes in EMG-activity were found. The EMG-activity of the descending part of the trapezius muscle was increased significantly for the total group during the strongest bite.