Journal of endodontics
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Journal of endodontics · Jul 2007
Measurement of mechanical allodynia and local anesthetic efficacy in patients with irreversible pulpitis and acute periradicular periodontitis.
An essential feature of symptomatic periradicular inflammation is mechanical allodynia, defined as reduced mechanical pain thresholds. A previous study evaluating a new digital force transducer showed that it reliably measures mechanical pain thresholds of teeth with normal periradicular tissues. In this study, we tested the hypothesis that the force transducer quantitatively measures mechanical allodynia in teeth with acute periradicular periodontitis (APP) and detects the effects of local anesthetic injection. ⋯ The administration of local anesthesia reversed the mechanical allodynia by 62%, and significant sex-specific effects were observed. In addition, the normal teeth contralateral to the symptomatic teeth had lower mechanical thresholds than those observed in healthy volunteers, suggesting that central sensitization occurs during this type of odontalgia. Thus, we show that the mechanical pain thresholds are significantly reduced in teeth with IP and APP and that the force transducer has potential application as a diagnostic aid in measuring mechanical allodynia and as an outcome measure in endodontic clinical trials such as pharmacologic studies and mechanistic research.
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Journal of endodontics · May 2007
Comparative StudyComparison of electrical, thermal, and pulse oximetry methods for assessing pulp vitality in recently traumatized teeth.
Pulse oximeter is a well-established and noninvasive method for measuring vascular health by evaluating oxygen saturation. This study compared the efficacy of a custom-made pulse oximeter dental probe with the electric pulp testing and thermal testing for measuring pulp vitality status of recently traumatized permanent teeth. ⋯ The proportion of recently traumatized teeth showing a positive responsiveness in thermal/electric pulp tests increased from no teeth showing responsiveness on day 0 to 29.4% teeth on the 28th day, 82.35% of teeth at 2 months, and 94.11% teeth at 3 months. However, pulse oximeter gave positive vitality readings that remained constant over the study period from day 0 to 6 months in all patients.
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Journal of endodontics · Apr 2007
Randomized Controlled Trial Comparative StudyComparison of 4% articaine with 1:100,000 epinephrine and 2% lidocaine with 1:100,000 epinephrine when used as a supplemental anesthetic.
A randomized, double-blind trial was conducted to compare the efficacy of 4% articaine with 1:100,000 epinephrine and 2% lidocaine with 1:100,000 epinephrine when used as a supplemental anesthetic. Forty-eight patients with irreversible pulpitis requiring supplemental buccal infiltration for endodontic therapy were given either 4% articaine with 1:100,000 epinephrine or 2% lidocaine with 1:100,000 epinephrine in a double-blind manner. ⋯ The mean percentage change in VAS score was 70.5 and 62.2% for articaine and lidocaine, respectively. There was no statistically significant difference in the VAS pain score between 4% articaine with 1:00,000 epinephrine and 2% lidocaine with 1:00,000 epinephrine as a supplemental anesthetic.
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Journal of endodontics · Apr 2007
Comparative Study Clinical TrialEvaluation of efficacy of a new custom-made pulse oximeter dental probe in comparison with the electrical and thermal tests for assessing pulp vitality.
Pulse oximetry is a noninvasive method of measuring vascular health by evaluating oxygen saturation. This study evaluated the efficacy of a new custom-made pulse oximeter dental probe in comparison with the electrical and thermal tests for assessing pulp vitality. ⋯ The specificity of the pulse oximeter was 0.95, as compared to 0.92 with the cold and electrical pulp tests. Thus, the custom-made pulse oximeter dental probe is an effective, accurate, and objective method of evaluating pulp vitality.
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Journal of endodontics · Jan 2007
Randomized Controlled TrialAnesthetic efficacy of lidocaine/meperidine for inferior alveolar nerve blocks in patients with irreversible pulpitis.
The purpose of this prospective, randomized, single-blind study was to compare the anesthetic efficacy of lidocaine with epinephrine to lidocaine plus meperidine with epinephrine for inferior alveolar nerve blocks (IAN) in patients with mandibular posterior teeth experiencing irreversible pulpitis. Forty-eight emergency patients diagnosed with irreversible pulpitis of a mandibular posterior tooth randomly received, in a single-blind manner, 36 mg of lidocaine with 18 mug epinephrine or 36 mg of lidocaine with 18 mug of epinephrine plus 36 mg meperidine with 18 mug epinephrine, using a conventional inferior alveolar nerve block. Endodontic access was begun 15 minutes after solution deposition, and all patients were required to have profound lip numbness. ⋯ The success rate for the inferior alveolar nerve block using the lidocaine solution was 26%, and for the lidocaine/meperidine solution, the success rate was 12%. There was no significant difference (p = 0.28) between the two solutions. In conclusion, for mandibular posterior teeth with irreversible pulpitis, the addition of 36 mg of meperidine to a lidocaine solution administered in a conventional IAN block did not improve the success rate over a standard lidocaine solution.