TO COMPARE THE EFFECTIVENESS OF INTRALIGAMENTARY INJECTION ANAESTHESIA VERSUS INFERIOR ALVEOLAR NERVE BLOCK TECHNIQUE IN EXTRACTION OF MANDIBULAR POSTERIOR TEETH - A RANDOMIZED CLINICAL STUDY.

BACKGROUND: Profound pulpal anaesthesia using the inferior alveolar nerve block (IANB) technique for extraction of mandibular posterior teeth is difcult to achieve. Several authors emphasised the effects of intraligamentary injection anaesthesia (ILA), also known as periodontal injection; as a primary or supplementary technique. The aim of this study was to compare the efcacy of ILA over IANB technique in providing adequate and superior anaesthesia for extraction of mandibular premolars and molars. MATERIALS AND METHODS: 30 patients requiring bilateral extractions of mandibular posterior teeth were selected. The parameters evaluated were subjective (numbness) and objective (pain on gingival probing) signs of anaesthesia, difference in pain perception during the procedure; and duration of anaesthesia for ILA (Group A) and IANB technique (Group B). RESULTS: The results showed that no difference was found in terms of subjective and objective evaluation of anaesthesia between the groups. A statistically signicant difference was seen in Group A, where intraligamentary injection anaesthesia showed less pain perception than the IANB technique. However, longer duration of anaesthesia was noted in Group B. CONCLUSION: With fewer failures and complications, the intraligamentary injection can be effectively used as a primary technique to alleviate pain and profoundly anaesthetize the mandibular posterior teeth during dento-alveolar extraction procedure.

Efficacy of Anaesthesia Techniques in Periapical Diseased Tooth

Almost all minor oral surgical procedures can be performed effectively if patient is relaxed and comfortable. One of the contributing factor for patient comfort is effective pain control. This can be achieved pre and per-operatively by various local anaesthetic techniques. Infiltration techniques are commonly employed in all maxillary and mandibular teeth whereas mandibular posterior teeth requires a nerve block. In certain cases, these techniques fails or provide inadequate anaesthesia, for example, teeth associated with periapical pathology. Therefore, we conducted a study to determine effectiveness of infiltration and block techniques as well as when supplemented by intra-ligament injection for anaesthesia in periapical infected teeth. Keywords: anaesthesia, infiltration technique, block technique, intraligamental technique, periapical pathology.

Clinical Management of Hypodontia of Two Mandibular Incisors

This article presents the clinical management of a patient with bilateral congenitally missing mandibular incisors. This condition is relatively rare and always needs a careful diagnosis and treatment planning. The chosen treatment strategy for this patient included space closure by protraction of the mandibular posterior teeth and canine substitution of missing incisors. Furthermore, the problems arising from this treatment plan, such as premolar-protected occlusion and tooth size discrepancy, are discussed. From the case presented in this study, we can conclude that space closure may be considered an efficient treatment approach for achieving satisfactory functional and aesthetic results.

RCT on the effectiveness of the intraligamentary anesthesia and inferior alveolar nerve block on pain during dental treatment

Objective To compare the effectiveness and complications of intraligamentary anesthesia (ILA) with conventional inferior alveolar nerve block (IANB) during injection and dental treatment of mandibular posterior teeth. Materials and methods In this randomized, prospective clinical trial, 72 patients (39 males, 33 females), scheduled for dental treatment of mandibular posterior teeth, were randomly allocated to ILA group (n = 35) received ILA injection or IANB group (n = 37) received the conventional IANB. Our primary outcome was to assess pain and stress (discomfort) during the injection and dental treatment, using the numeric rating scale (NRS) from 0 to 10 (0 = no pain, 10= the worst pain imaginable), whereas recording 24-h postoperative complications was our secondary outcomes. Results Patients in ILA group reported significantly less pain during injection when compared with IANB group (p = 0.03), while pain during dental treatment was similar in both groups (p = 0.2). Patients in both groups also reported similar law values of discomfort during treatment (p = 0.7). Although no signs of nerve contact or any other postoperative complications were observed, five patients in IANB group (none in ILA group) reported temporary irritations. Conclusion This study showed equivalent effectiveness of both intraligamentary anesthesia and conventional inferior alveolar nerve block, for pain control during routine dental treatment of mandibular posterior teeth. Nevertheless, ILA showed significantly less pain during injection. No major postoperative complications in both groups were observed. Clinical relevance ILA could be considered as an effective alternative for routine dental treatment. Trial registration NCT04563351

Comparative Evaluation of The Type of Sealer Used For Obturation of Single Visit Root Canal Treated Maxillary and Mandibular Posterior Teeth- A Retrospective Analysis

Single visit root canal therapies are indicated when no periapical changes are appreciated. The final stage of the root canal treatment deals with the filling of the canal system with a biocompatible material. Obturation comprises a core filling material and a sealer. The study aimed to evaluate the type of sealer used for obturation of posterior teeth treated in a single visit and to correlate the sealer use with factors like tooth, gender and operator qualification. The study was a retrospective analysis. A total of 86,000 case sheets were reviewed and necessary data was extracted. The type of sealer used for the obturation was assessed and tabulated along with details like age, gender and tooth. The data was exported to IBM SPSS Software 20. Frequency distribution tables were created and a Chi-square test was performed to check for the correlation of the type of sealer used with various parameters. A total of 1209 molar cases were treated out of which 34.5% were maxillary first molars. The endodontic sealers that have been reported to be put to use are zinc oxide based, resin-based, calcium hydroxide based, medicated, 3 sealer, 4 sealer & others. Maximum cases (53.5%) were treated with a resin-based sealer. A positive correlation (p-value <0.05) is found between the use of sealer and operator qualification. Within the limitations of the study, a variety of root canal sealers were found to have been used for obturation and a positive correlation between the operator qualification & type of sealer used for obturation of molars in single visit RCTs was found.