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The effectiveness of Xylocaine as a local anesthetic agent has been studied (1) by measuring tooth response to graded electrical stimulation. and (2) by observing clinical effectiveness in dental surgical procedures. From these studies, the following conclusions are justified: 1. 1. Xylocaine produces a more profound anesthesia than does procaine. Since rapidity of action, spread, and duration of anesthesia may be a function of depth of anesthesia, any conclusions concerning these factors are limited to the volumes and concentrations used in this particular study. 2. 2. The onset of anesthesia is more rapid with Xylocaine than with procaine. 3. 3. The spread of anesthesia is greater with Xylocaine. 4. 4. Duration of anesthesia is longer with Xylocaine. 5. 5. No differences were noted in blood pressures, pulse, amount of pain, bleeding, and the number of untoward incidents at operation, nor in the amount of postoperative pain.

This is a case report of a large complex composite odontoma and its surgical treatment. The presence of infection complicated treatment and had to be controlled prior to surgery. A two-stage procedure was contemplated wherein the wound would be packed open with fine mesh gauze and secondary closure effected after complete subsidence of infection. This was ruled out, as it was felt that the infection was well controlled and adequate drainage would be accomplished with a Penrose drain, giving the patient a shorter recovery period and a better cosmetic result. The extraoral approach was by far the best in a lesion of this size and position. Intraoral approach would be fraught with many difficulties, some of which are lack of access, excessive trauma, and possible sacrifice of healthy teeth. In this type of case, a possible fracture of the mandible must be anticipated and prepared for before surgery. Although a tentative diagnosis was made on the basis of the x-ray findings, other diagnoses cannot be ruled out until microscopic examination of the lesion is completed.