scholarly journals Anesthetic Efficacy of a Combination of 0.5 M Mannitol Plus 36.8 mg of Lidocaine With 18.4 μg Epinephrine in Maxillary Infiltration: A Prospective, Randomized, Single-Blind Study

2014 ◽  
Vol 61 (2) ◽  
pp. 63-68 ◽  
Author(s):  
Kevin Younkin ◽  
Al Reader ◽  
Melissa Drum ◽  
John Nusstein ◽  
Mike Beck
Keyword(s):  
Postoperative Pain ◽  
Blind Study ◽  
Lateral Incisor ◽  
Maximum Output ◽  
Control Solution ◽  
Solution Deposition ◽  
Maxillary Lateral Incisor ◽  
The Subject ◽  
Pulpal Anesthesia ◽  
Single Blind

Abstract The purpose of this prospective, randomized, single-blind study was to determine the anesthetic efficacy of lidocaine with epinephrine compared to lidocaine with epinephrine plus 0.5 M mannitol in maxillary lateral incisor infiltrations. Forty-one subjects randomly received 2 maxillary lateral infiltrations consisting of a 1.84-mL solution of 36.8 mg lidocaine with 18.4 μg epinephrine (control solution) and a 2.90-mL solution of 36.8 mg lidocaine with 18.4 μg epinephrine (1.84 mL) plus 0.5 M mannitol (1.06 mL) in 2 separate appointments spaced at least 1 week apart. The maxillary lateral incisor was blindly electric pulp–tested in 2-minute cycles for 60 minutes postinjection. No response from the subject to the maximum output (a reading of 80) of the pulp tester was used as the criterion for pulpal anesthesia. Total percent pulpal anesthesia was defined as the total of all pulpal anesthesia readings (at output of 80) over the 60-minute test period. Pain during solution deposition and postoperative pain were also measured. The results demonstrated that a 2.90-mL solution of 36.8 mg lidocaine with 18.4 μg epinephrine (1.84 mL) plus 0.5 M mannitol (1.06 mL) was not statistically significantly superior to a 1.84-mL solution of 36.8 mg lidocaine with 18.4 μg epinephrine. The pain of solution deposition was lower with the lidocaine/mannitol formulation. Postoperative pain was not statistically significantly different between the lidocaine/mannitol formulation and the lidocaine formulation without mannitol. We concluded that adding 0.5 M mannitol to a lidocaine with epinephrine formulation was not significantly more effective in achieving a greater percentage of total pulpal anesthesia (as defined in this study) than a lidocaine formulation without mannitol in the maxillary lateral incisor.

scholarly journals Anesthetic Efficacy of a Combination of 0.5 M Mannitol Plus 127.2 mg of Lidocaine With 50 μg Epinephrine in Inferior Alveolar Nerve Blocks: A Prospective Randomized, Single-Blind Study

2013 ◽  
Vol 60 (1) ◽  
pp. 3-10 ◽  
Author(s):  
Steven Smith ◽  
Al Reader ◽  
Melissa Drum ◽  
John Nusstein ◽  
Mike Beck
Keyword(s):  
Postoperative Pain ◽  
Inferior Alveolar Nerve ◽  
Blind Study ◽  
Maximum Output ◽  
Nerve Blocks ◽  
Posterior Teeth ◽  
Solution Deposition ◽  
The Times ◽  
Pulpal Anesthesia ◽  
Single Blind

Abstract The purpose of this prospective, randomized, single-blind study was to determine the anesthetic efficacy of 127.2 mg lidocaine with 50 μg epinephrine compared to 127.2 mg lidocaine with 50 μg epinephrine plus 0.5 M mannitol in inferior alveolar nerve (IAN) blocks. Forty subjects randomly received 2 IAN blocks consisting of a 3.18 mL formulation of 127.2 mg lidocaine with 50 μg epinephrine and a 5 mL formulation of 127.2 mg lidocaine with 50 μg epinephrine (3.18 mL) plus 0.5 M mannitol (1.82 mL) in 2 separate appointments spaced at least 1 week apart. Mandibular anterior and posterior teeth were blindly electric pulp tested at 4-minute cycles for 60 minutes postinjection. Pain of solution deposition and postoperative pain were also measured. No response from the subject to the maximum output (80 reading) of the pulp tester was used as the criterion for pulpal anesthesia. Total percent pulpal anesthesia was defined as the total of all the times of pulpal anesthesia (80 readings) over the 60 minutes. One hundred percent of the subjects had profound lip numbness with both inferior alveolar nerve blocks. The results demonstrated that a 5 mL formulation of 127.2 mg lidocaine with 50 μg epinephrine plus 0.5 M mannitol was significantly better than the 3.18 mL formulation of 127.2 mg lidocaine with 50 μg epinephrine for all teeth. Solution deposition pain and postoperative pain were not statistically different between the lidocaine/mannitol formulation and the lidocaine formulation without mannitol. We concluded that adding 0.5 M mannitol to a lidocaine with epinephrine formulation was significantly more effective in achieving a greater percentage of total pulpal anesthesia than a lidocaine formulation without mannitol.

scholarly journals Anesthetic Efficacy of Combinations of 0.5 M Mannitol and Lidocaine With Epinephrine in Inferior Alveolar Nerve Blocks: A Prospective Randomized, Single-Blind Study

2011 ◽  
Vol 58 (4) ◽  
pp. 157-165 ◽  
Author(s):  
Ronald Wolf ◽  
Al Reader ◽  
Melissa Drum ◽  
John Nusstein ◽  
Mike Beck
Keyword(s):  
Postoperative Pain ◽  
Inferior Alveolar Nerve ◽  
Blind Study ◽  
Maximum Output ◽  
Nerve Blocks ◽  
Solution Deposition ◽  
The Times ◽  
Pulpal Anesthesia ◽  
Single Blind ◽  
Better Than

Abstract The purpose of this prospective, randomized, single-blind study was to determine the anesthetic efficacy of lidocaine with epinephrine compared to lidocaine with epinephrine plus 0.5 M mannitol in inferior alveolar nerve (IAN) blocks. Forty subjects randomly received an IAN block in 3 separate appointments spaced at least 1 week apart using the following formulations: a 1.8 mL solution of 36 mg lidocaine with 18 µg epinephrine (control solution); a 2.84 mL solution of 36 mg lidocaine with 18 µg epinephrine (1.80 mL) plus 0.5 M mannitol (1.04 mL); and a 5 mL solution of 63.6 mg lidocaine with 32 µg epinephrine (3.18 mL) plus 0.5 M mannitol (1.82 mL). Mandibular teeth were blindly electric pulp tested at 4-minute cycles for 60 minutes postinjection. No response from the subject to the maximum output (80 reading) of the pulp tester was used as the criterion for pulpal anesthesia. Mean percent total pulpal anesthesia was defined as the total of all the times of pulpal anesthesia (80 readings) over the 60 minutes. Pain of solution deposition and postoperative pain were also measured. The results demonstrated that 2.84 mL of lidocaine with epinephrine plus 0.5 M mannitol was significantly better than 1.8 mL of lidocaine with epinephrine for the molars and premolars. The 5 mL of lidocaine with epinephrine plus 0.5 M mannitol was statistically better than 1.8 mL of lidocaine with epinephrine and 2.84 mL of lidocaine with epinephrine plus 0.5 M mannitol for all teeth except the central incisor. Solution deposition pain and postoperative pain were not statistically different among the mannitol formulations and the lidocaine formulation without mannitol. We concluded that adding 0.5 M mannitol to lidocaine with epinephrine formulations significantly improved effectiveness in achieving a greater percentage of total pulpal anesthesia compared with a lidocaine formulation without mannitol for IAN block.

scholarly journals Anesthetic Efficacy of a Combination of 0.9 M Mannitol Plus 68.8 mg of Lidocaine With 50 μg Epinephrine in Inferior Alveolar Nerve Blocks: A Prospective Randomized, Single Blind Study

2013 ◽  
Vol 60 (4) ◽  
pp. 145-152 ◽  
Author(s):  
Howard Cohen ◽  
Al Reader ◽  
Melissa Drum ◽  
John Nusstein ◽  
Mike Beck
Keyword(s):  
Inferior Alveolar Nerve ◽  
Blind Study ◽  
Maximum Output ◽  
Nerve Blocks ◽  
Posterior Teeth ◽  
The Subject ◽  
Mandibular Teeth ◽  
The Times ◽  
Pulpal Anesthesia ◽  
Single Blind

Abstract The purpose of this prospective randomized, single blind study was to determine the anesthetic efficacy of 68.8 mg of lidocaine with 50 μg epinephrine compared to 68.8 mg lidocaine with 50 μg epinephrine plus 0.9 M mannitol in inferior alveolar nerve (IAN) blocks. Forty subjects randomly received 2 IAN blocks consisting of a 1.72-mL formulation of 68.8 mg lidocaine with 50 μg epinephrine and a 5-mL formulation of 68.8 mg lidocaine with 50 μg epinephrine (1.72 mL) plus 0.9 M mannitol (3.28 mL) in 2 separate appointments spaced at least 1 week apart. Mandibular anterior and posterior teeth were blindly electric pulp tested at 4-minute cycles for 60 minutes postinjection. No response from the subject to the maximum output (80 reading) of the pulp tester was used as the criterion for pulpal anesthesia. Total percent pulpal anesthesia was defined as the total of all the times of pulpal anesthesia (80 readings), for each tooth, over the 60 minutes. One hundred percent of the subjects had profound lip numbness with both inferior alveolar nerve blocks. The results demonstrated that the 5 mL-formulation of 68.8 mg lidocaine with 50 μg epinephrine plus 0.9 M mannitol was significantly better than the 1.72-mL formulation of 68.8 mg lidocaine with 50 μg epinephrine for all teeth, except the lateral incisor. We concluded that adding 0.9 M mannitol to a lidocaine with epinephrine formulation was significantly more effective in achieving a greater percentage of total pulpal anesthesia (as defined in this study) than a lidocaine formulation without mannitol. However, the 0.9 M mannitol/lidocaine formulation would not provide 100% pulpal anesthesia for all the mandibular teeth.

scholarly journals Pulpal Anesthesia of Adjacent Teeth Following Infiltration of 2% Lidocaine With 1:100,000 Epinephrine in the Maxillary Lateral Incisor and First Molar

2019 ◽  
Vol 66 (1) ◽  
pp. 14-19
Author(s):  
Sara Fowler ◽  
Melissa Drum ◽  
Al Reader ◽  
John Nusstein ◽  
Mike Beck
Keyword(s):  
Local Anesthesia ◽  
Repeated Measures ◽  
Lateral Incisor ◽  
Maximum Output ◽  
Central Incisor ◽  
Second Molar ◽  
Asymptomatic Patients ◽  
Maxillary Lateral Incisor ◽  
Asymptomatic Subjects ◽  
Pulpal Anesthesia

The purpose of this study was to determine anesthetic success in adjacent teeth following a primary infiltration of the maxillary lateral incisor and first molar using 1.8 mL of 2% lidocaine with 1:100,000 epinephrine. Three hundred eight asymptomatic subjects received an infiltration of a cartridge of 2% lidocaine with 1:100,000 epinephrine over the maxillary lateral incisor (163 subjects) or first molar (145 subjects). Pulpal anesthesia of the injected tooth and adjacent mesial and distal teeth was monitored with the electric pulp tester in 2-minute cycles for a total of 60 minutes. No response from the subject at the maximum output (80 reading) of the pulp tester was used as the criterion for pulpal anesthesia. Comparisons of the odds of pulpal anesthesia (defined as an 80/80 response to electric pulp testing over 60 minutes) between the experimentally injected tooth and adjacent teeth were analyzed using mixed-models, repeated-measures logistic regression. When compared with the lateral incisor infiltration, the adjacent mesial tooth (central incisor) and distal tooth (canine) achieved statistically lower anesthetic success. When compared with the first molar, the mesial tooth (second premolar) did not differ statistically. However, significant differences were shown between the first molar and the second molar, with the distal tooth (second molar) achieving a statistically higher rate of pulpal anesthesia, which was related to a better duration of anesthesia. For asymptomatic patients, local anesthesia of the adjacent mesial (central incisor) and distal (canine) teeth to the infiltrated lateral incisor had lower pulpal anesthetic success. Because standard infiltration anesthesia of the lateral incisor is of short duration, repeating the infiltration at 30 minutes will result in a high incidence of pulpal anesthesia for 60 minutes. Local anesthesia of the adjacent distal tooth to the first molar (second molar) had a statistically higher rate of total pulpal anesthesia than the infiltrated first molar due to the longer duration of pulpal anesthesia. However, if pulpal anesthesia is required for 60 minutes in the first and second molars, the clinician may need to add an additional infiltration to ensure anesthesia.

scholarly journals The Effects of a Preoperative Steroid/Anesthetic Injection on Post-Tonsillectomy Pain

2003 ◽  
Vol 82 (4) ◽  
pp. 305-308 ◽  
Author(s):  
Timothy M. Cupero ◽  
Sam Y. Kim ◽  
Andrew B. Silva
Keyword(s):  
Statistical Analysis ◽  
Postoperative Pain ◽  
Active Treatment ◽  
Generalized Estimating Equations ◽  
Blind Study ◽  
Significant Difference ◽  
The Right ◽  
And Control ◽  
To Receive ◽  
Single Blind

We conducted a placebo-controlled, single-blind study to determine the efficacy of a local preoperative injection of a steroid/anesthetic combination in preventing post-tonsillectomy pain. We randomized 21 adults to receive either triamcinolone/bupivacaine on the left side and saline on the right or vice versa. Injections were administered in the area of the tonsillar pillars following intubation and prior to tonsillectomy. Based on the “generalized estimating equations” model of statistical analysis, we found no significant difference in the degree of postoperative pain between the active-treatment and control sides.

scholarly journals A Prospective, Randomized, Double-Blind Comparison of 2% Lidocaine With 1 : 100,000 Epinephrine, 4% Prilocaine With 1 : 200,000 Epinephrine, and 4% Prilocaine for Maxillary Infiltrations

2010 ◽  
Vol 57 (2) ◽  
pp. 45-51 ◽  
Author(s):  
Steven Katz ◽  
Melissa Drum ◽  
Al Reader ◽  
John Nusstein ◽  
Mike Beck
Keyword(s):  
Crossover Study ◽  
Lateral Incisor ◽  
Anesthetic Agent ◽  
Double Blind ◽  
Maxillary Lateral Incisor ◽  
Blind Comparison ◽  
Blind Manner ◽  
Pulpal Anesthesia ◽  
Blind Crossover Study ◽  
Double Blind Crossover Study

Abstract The purpose of this prospective, randomized, double-blind crossover study was to evaluate the anesthetic efficacy of 2% lidocaine with 1 : 100,000 epinephrine, 4% prilocaine with 1 : 200,000 epinephrine, and 4% prilocaine in maxillary lateral incisors and first molars. Sixty subjects randomly received, in a double-blind manner, maxillary lateral incisor and first molar infiltrations of 1.8 mL of 2% lidocaine with 1 : 100,000 epinephrine, 1.8 mL of 4% prilocaine with 1 : 200,000 epinephrine, and 1.8 mL of 4% prilocaine, at 3 separate appointments spaced at least 1 week apart. The teeth were pulp-tested in 3-minute cycles for a total of 60 minutes. Anesthetic success (ie, obtaining 2 consecutive 80 readings with the electric pulp tester) and onset of pulpal anesthesia were not significantly different between 2% lidocaine with 1 : 100,000 epinephrine, 4% prilocaine with 1 : 200,000 epinephrine, and 4% prilocaine for the lateral incisor and first molar. For both lateral incisor and first molar, 4% prilocaine with 1 : 200,000 epinephrine and 2% lidocaine with 1 : 100,000 epinephrine were equivalent for incidence of pulpal anesthesia. However, neither anesthetic agent provided an hour of pulpal anesthesia. For both lateral incisor and first molar, 4% prilocaine provided a significantly shorter duration of pulpal anesthesia compared with 2% lidocaine with 1 : 100,000 epinephrine and 4% prilocaine with 1 : 200,000 epinephrine.

Influence of Vitamin E on Plasma Malondialdehyde- Like Material in Man

1984 ◽  
Vol 51 (03) ◽  
pp. 347-348 ◽  
Author(s):  
C Cordova ◽  
A Musca ◽  
F Violi ◽  
C Alessandri ◽  
A Ghiselli ◽  
...  
Keyword(s):  
Vitamin E ◽  
Healthy Subjects ◽  
Placebo Treatment ◽  
Blind Study ◽  
Single Blind ◽  
Plasma Malondialdehyde

SummaryThe behaviour of plasma malondialdehyde-like material (MDA-LM) was evaluated in 13 healthy subjects by a single-blind study that consisted of placebo (30 days), vitamin E treatment (300 mg/day) (30 days) and placebo (30 days). The study demonstrated that MDA-LM did not change during placebo treatment while it significantly decreased after vitamin E administration.

Impact of oral-health-related quality of life and self-esteem on patients with missing maxillary lateral incisor after orthodontic space closure: a single-blinded, randomized, controlled trial

2020 ◽  
Author(s):  
Matheus Melo Pithon ◽  
Eduardo Otero Amaral Vargas ◽  
Raildo da Silva Coqueiro ◽  
Rogério Lacerda-Santos ◽  
Orlando Motohiro Tanaka ◽  
...  
Keyword(s):  
Oral Health ◽  
Controlled Trial ◽  
Phase 1 ◽  
Self Esteem ◽  
Lateral Incisor ◽  
Phase 2 ◽  
Space Closure ◽  
Related Quality ◽  
Health Related ◽  
Maxillary Lateral Incisor

Summary Background The maxillary lateral incisor is one of the teeth most likely to suffer agenesis, resulting in spacing between the central incisor and the canine. Objective To compare maxillary lateral incisor agenesis with space closure treatment versus non-treatment based on measurements of the self-perceived oral-health-related quality of life (OHRQoL) and self-esteem of the participants. Subjects and methods A total of 44 people, aged 17–49 years, with missing lateral incisors were randomly assigned to two groups (n = 22 in each)—a treated group in which the space was orthodontically closed (TG) and a control group that remained untreated (CG). Randomization was performed by a researcher who was not involved in the clinical part of the study. The outcomes were assessed using the Oral Health Impact Profile and Rosenberg’s Self-Esteem Scale, which were applied before (phase 1) and after (phase 2) the orthodontic treatment in the TG, and at baseline (phase 1) and 12 months after (phase 2) in the CG. All the data were blindly evaluated, supporting the single-blinded design of the study. Results All participants finished the randomized controlled trial, and the demographic characteristics were similar between the groups. In phase 1, the levels of self-esteem and OHRQoL at baseline were similar (P = 0.079, P = 0.693, respectively). In phase 2, the self-esteem scores of the CG decreased and the OHRQoL increased (P = 0.005, P < 0.001, respectively), while self-esteem increased in the TG and the OHRQoL decreased (P < 0.001). The CG had lower scores than the TG for self-esteem, but the opposite was observed for OHRQoL (P < 0.001). Limitations Information bias may have occurred. Since the questionnaires could not have been applied at the same time in both groups, the time difference between the two assessments may have led to random and systematic error. Conclusions The spacing resulting from missing maxillary lateral incisors had a negative impact on the OHRQoL and self-esteem of the participants, while orthodontically closing those spaces had a positive impact on those aspects. Clinical trial registration This study was not registered. Protocol The protocol was not published before trial commencement.

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