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Aim To compare the anaesthetic efficacy of inferior alveolar nerve blocks (IANB) with 1.8 mL of 2% lidocaine (LI) to a buccal infiltration (BI) with 1.8 mL of 4% articaine (AR), both with 1 : 100 000 epinephrine, in patients with symptomatic irreversible pulpits in a randomized controlled trial. Methodology Volunteers presenting at the Emergency Centre ( FOP- UNICAMP) were randomly divided into two groups (30 for AR and 20 for LI). Operator and patient were not blinded. Success was recorded when complete pain-free treatment was achieved after a single injection ( IANB or BI) or when one supplemental injection was needed for emergency endodontic procedures. Success rate of supplemental injection was evaluated between and within groups using Fisher's exact test and chi-square test. Results A higher success rate ( P = 0.03/Fisher's exact test) was observed with AR (40%) than with LI (10%). No significant difference was found when a single injection plus one supplemental injection was compared between groups ( P = 1.0; AR = 70%; LI = 80%). However, supplemental injection increased the anaesthetic success rates ( AR, P = 0.04; LI, P = 0.0001) within groups. Conclusions Single anaesthesia techniques ( IANB or BI) were not able to achieve pain-free emergency endodontic treatment. Supplemental anaesthetic techniques should be considered prior to treatment procedures in order to increase success rate (consort: registration number - NCT01912755/Fapesp: #2009/10834-4). [ABSTRACT FROM AUTHOR]

Objective: The aim of this study was to identify which local anaesthetic solutions were used by general dental practitioners in the United Kingdom and to determine selection criteria. In addition, differences in anaesthetic choice between recent graduates (< or = 5 years) and more experienced practitioners were investigated. Material and Methods: Five hundred and six general dental practitioners attending postgraduate courses on pain control in dentistry completed a questionnaire. Participants were asked to indicate year and place of qualification, anaesthetic solutions available in their surgeries and criteria used in the choice of anaesthetic. In addition, the respondents were asked to indicate choice of local anaesthetic in a number of common medical conditions. Questionnaires were distributed and collected immediately prior to the start of the course presentation and participants were not asked to indicate whether the selection decisions were teaching, experience or evidence based. Data were analysed by using the Chi-square test. Results: Lidocaine with epinephrine was the most widely available solution among this group of practitioners (94%), the second most common solution was prilocaine with felypressin (74%). The majority of practitioners had two or more solutions available. Practitioners who qualified within the last five years (14%) were more likely to have articaine available, the most recently introduced local anaesthetic into the UK (p = 0.04, one degree of freedom). Common medical conditions lead to a modification in anaesthetic selection: the use of prilocaine/felypressin increases in the majority of circumstances, although it is avoided in pregnant females by recent graduates. Conclusions: Lidocaine/epinephrine continues to be the most common anaesthetic solution used by this group of UK general practitioners. The primary criterion for selection of an anaesthetic agent was perceived efficacy. Prilocaine/felypressin is commonly selected as an alternative solution in the presence of common medical conditions. [ABSTRACT FROM AUTHOR]

The present study correlated the mineralization of third molars to chronological age using a modified classification based on Demirjian's stages in a Brazilian subpopulation and compared with the original classification. A total of 1082 patients with age ranging from 6 to 26 years were included in the sample, with at least one third molar on panoramic radiographs. The third molars were classified according to the original Demirjian classification (8 stages) and a new model based on the Demirjian method, where the original stages were grouped into four stages: AB—enamel mineralization; CD—crown dentin mineralization; EFG—root formation; and H—complete development. Statistical analyses were performed by Kruskal-Wallis/Dunn tests (α = 0.05) and the multinomial logistic regression model. Data were analyzed according to percentiles for the probability of an individual being over 18 years old. The mean ages of the stages in both classifications did not present a significant difference between superior and inferior arches (p < 0.05). The differences in mean ages between all the stages of mineralization were statistically significant (p < 0.001) only for the 4-stage classification. Males attained root formation and complete formation earlier than females (p < 0.05) in the 4-stage classification. The modified classification system showed dependence between chronological age and mineralization stages of third molars, simplifying the age estimation process. At stage H, females present a 95.7% chance of being over 18, while for males, this probability is 89.6%. This modified classification system simplifies the dental age estimation process based on third molars and can be used as a reference for future studies. [ABSTRACT FROM AUTHOR]

This study reports four cases of mucosa ulceration after a 30-minute application of EMLA (0.3 g) as a topical anaesthetic in dentistry. The subjects returned the next day with a white ulceration and desquamation on the application site. EMLA cream should not be applied to the oral mucosa for 30 minutes. [ABSTRACT FROM AUTHOR]