Int Dent J
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Review Meta Analysis Comparative Study
Efficacy and safety of mepivacaine compared with lidocaine in local anaesthesia in dentistry: a meta-analysis of randomised controlled trials.
The objective of the study was to assess the efficacy and safety of mepivacaine compared with lidocaine used in local anaesthesia in dentistry. Medline, Cochrane Central Register of Controlled Trials, EMBASE, Chinese BioMedical Literature Database, China National Knowledge Infrastructure and WHO International Clinical Trials Registry Platform were searched electronically. Relevant journals and references of studies included were hand-searched for randomised controlled trials comparing mepivacaine with lidocaine in terms of efficacy and safety. ⋯ In addition, 3% mepivacaine had shorter onset time (P = 0.004), same level of success rate (P = 0.28) and similar pain control during injection and postinjection compared with 2% lidocaine with 1:50,000 adrenaline. Given the efficacy and safety of the two solutions, 2% mepivacaine with vasoconstrictors is better than 2% lidocaine with vasoconstrictors in dental treatment. Meanwhile, 3% plain mepivacaine is better for patients with cardiac diseases.
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There has been a great deal of research describing the risk factors and determinants that impact on the health and well being of Aboriginal Canadians that has revealed tremendous oral health inequalities between these groups and their non-Aboriginal counterparts. Building on this research, culturally-based preventive interventions are now needed to address the significantly higher rates of oral disease among Aboriginals across Canada. ⋯ Particular emphasis is placed upon community-based and national initiatives to prevent dental caries in young Indigenous children that begin by improving the oral and general health of young women and mothers through pre-conception interventions. In addition, recently developed and implemented national First Nations- and Inuit-led oral health surveys are set to provide new evidence to inform future programmes and policy initiatives that will help to reduce dental disease burden and inequalities affecting Indigenous Canadians.
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Quality has always been important for the health professions. However, recently the 'pressure' for quality assurance/improvement (QA/I) in the health care arena has increased. All health professions and individual practitioners are expected to be aware of the driving forces behind this increasing 'pressure' for quality to be able to meet the demands for the continuous QA/I. It is particularly important to have a correct understanding of the QA/I process, the shared values, goals and potential benefits of the different QA/I systems and tools, and the associated complexities of implementation of QA/I systems/models in health care.
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Hidden caries is a term used to describe occlusal dentine caries that is missed on a visual examination, but is large enough and demineralised enough to be detected radiographically. The detection rate of such lesions will depend upon the prevalence of caries in the population and the frequency with which bitewing radiographic examinations are performed. ⋯ However, this possibility has yet to be tested clinically and until it is, practising dentists would be wise to examine bitewing radiographs carefully for occlusal demineralisation. The authors would treat such hidden lesions by removing soft caries and placing sealant restorations.
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Dental education is dynamic. Many factors--economic, pedagogical, managerial, logistic, trends in disease patterns and delivery systems--are influencing its future directions and relationships with medical and other health professions' education. This article attempts to highlight those trends and relationships, at least in part of the world.