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Background: The authors evaluated published evidence from controlled clinical trials regarding the efficacy of two local anesthetic solutions in providing successful pulpal anesthesia., Methods: The authors searched MEDLINE and Embase databases to identify peer-reviewed randomized controlled trials in which researchers directly compared articaine and lidocaine local anesthetic solutions in adult participants. They extracted study characteristics and outcomes data as a basis for meta-analysis. They completed subgroup analyses for both infiltration and mandibular inferior alveolar block anesthetic techniques., Results: Articaine solutions had a probability of achieving anesthetic success superior to that of lidocaine, with an odds ratio of 2.44 (95 percent confidence interval [CI], 1.59-3.76; P < .0001). The greater odds ratio for articaine increased to 3.81 (95 percent CI, 2.71-5.36; P < .00001) when the authors analyzed only infiltration data. There was weaker, but still significant, evidence of articaine's being superior to lidocaine for mandibular block anesthesia, with an odds ratio of 1.57 (95 percent CI, 1.12-2.21; P = .009), and no difference when the authors considered only symptomatic teeth., Clinical Implications: Research evidence supports using articaine versus lidocaine for achieving pulpal anesthesia when the infiltration mode of administration is used. It is premature to recommend articaine for mandibular block anesthesia in cases involving irreversible pulpitis.

Introduction: The purpose of this pilot study was to examine how group supervision may help junior doctors recognize the learning potential in difficult on-the-job situations., Material and Methods: Eight junior doctors from an internal medicine department participated in a group supervision project during three months in the spring of 2007. Two supervisors from the hospital's Human Resource Department facilitated the process. The main themes and cases were related to the profession and not to private problems or aspects of biomedical knowledge. At the end of the project, all participants filled out an evaluation questionnaire consisting of qualitative as well as quantitative questions., Results: After the group supervision sessions, the doctors felt better equipped to meet the challenges of everyday work and had discovered the value of using each other as colleagues. Furthermore, they stated that the method had helped them improve their professional and managerial competencies as well as their ability to cooperate. Seven of the eight participants would participate in group-supervision again if possible. Participants' absence was mostly due to overtime work, being on call or being out of town., Conclusion: The results indicate that group supervision can be beneficial for junior doctors as it illustrates to them the learning potential of the difficult professional situations that inevitably occur on the job. When working with personal reflection in a supervision group, junior doctors realise how many doubts and thoughts they have in common, and how they can benefit from each other in addressing these issues. Success is dependent on high motivation and good planning.