Compendium of continuing education in dentistry
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With little room for error and recent reports of abuse and deaths, propofol, a commonly used general anesthetic induction agent, has provoked considerable concern and has stirred debate regarding its classification and how care should be rendered. The drug, when abused, presents a risk for psychological dependence, and studies have indicated an increase in the rate of propofol abuse, particularly among individuals in academic anesthesia programs. ⋯ When determining whether to administer propofol to patients, practitioners should bear in mind certain precluding factors, such as allergies to egg and soy. The narrow margin for error, the lack of a reversal agent, and risk for death make diligent and vigilant care imperative.
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Compend Contin Educ Dent · Feb 2013
Randomized Controlled Trial Comparative StudyFaster onset and more comfortable injection with alkalinized 2% lidocaine with epinephrine 1:100,000.
The pH of lidocaine with epinephrine in dental cartridges ranges between 2.9 and 4.4. In this pH range, less than 0.1% of the anesthetic is in the de-ionized or "active" form. The acidity of the anesthetic may delay onset and contribute to injection pain. ⋯ Clinicians can begin procedures more quickly and give a more comfortable injection by alkalinizing their lidocaine/epinephrine immediately before delivering the injection.
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Compend Contin Educ Dent · Jun 2012
Comparative StudyComparison of load-fatigue performance of posterior ceramic onlay restorations under different preparation designs.
The objective of this study was to evaluate the load-fatigue performance of posterior ceramic onlay restorations relative to two variables: preparation design (with or without buccal veneers); and the existing amount of tooth structure (non-worn tooth, worn tooth). ⋯ The addition of a buccal veneer component had no significant effect on the load-fatigue performance of posterior ceramic onlay restorations, but the existing amount of tooth structure did have a significant effect on the load-fatigue performance of posterior ceramic onlay restorations. Catastrophic failures (ceramic fracture) occurred only in the group of worn tooth.
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Compend Contin Educ Dent · Feb 2012
SPRIX (ketorolac tromethamine) nasal spray: a novel nonopioid alternative for managing moderate to moderately severe dental pain.
In summary, SPRIX is a nonopioid alternative for the management of moderate to moderately severe pain. SPRIX offers dentists, physicians, and patients a new non-opioid option to control acute moderate to moderately severe pain in situations in which use of an IM or IV access is not feasible or not wanted. ⋯ Currently, there are no nonopioid alternatives for the treatment of moderate to moderately severe pain other than ketorolac. In patients with more severe pain states, the combination of opioids and SPRIX provides unique advantages in maximizing analgesia while minimizing the unwanted adverse effects of both classes of drugs (referred to as multimodal or "balanced analgesia").
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Peripheral ossifying fibroma (POF) is a common solitary gingival overgrowth thought to arise from the gingival corium, periosteum, and periodontal ligament. Commonly used synonyms for POF include calcifying fibroblastic granuloma, peripheral fibroma with calcification, peripheral cementifying fibroma, and calcifying or ossifying fibrous epulis. Because it is possible to misdiagnose POF as pyogenic granuloma, peripheral giant cell granuloma, or odontogenic tumors, histopathological examination is, therefore, essential for accurate diagnosis, and differential diagnosis is important because of POF's tendency to recur. This article presents a case of peripheral ossifying fibroma in a 15-year-old female along with the clinical, histopathologic, and radiographic features and treatment details.