Pain and anxiety reduction using a manual stimulation distraction device when administering local analgesia oro-dental injections: a multi-center clinical investigation

OBJECTIVE: This study was designed to assess the effects of a manual stimulating distraction device (Isoflex referred to as Manual Stimulation Distraction Device or MSDD) for reducing pain and anxiety experienced with standard dental local anesthetic injections. Additionally, the memory recall effects on injection pain and anxiety were also explored. METHODOLOGY: Patients from different dental clinics were identified by their practitioners as requiring dental procedures under local anesthesia, in the same area on both sides of the mouth. A local anesthetic solution was injected on either the left or right side at different times by random selection; one side using MSDD, while the opposite side used a solution without MSDD. Each patient acted as his or her own symmetrical split-mouth control. The same dentist administered both injections, using identical technique and equipment for each side. Forty-six patients used the MSDD first with the injection, while 54 used MSDD second when they received the injection. Using 10-point visual analogue nominal and ordinal scales, pain and stress were recorded by the patient each time after receiving the injection. The results were pooled and subjected to statistical analysis. Student's paired t-test was employed to test for significant differences in pain and anxiety (stress) when injections were administered with and without MSDD. RESULTS: Results showed significant reductions in perceived pain and stress from local analgesia injections (p < 0.001) when MSDD was used. There was no correlation of pain reduction with age, gender, upper or lower jaw, with or without MSDD. There was a trend for pain and stress to be scored higher for those subjects who had a lower period since the first injection (POFI) scores. This was attributed to recent memory of pain, as POFI scores over one week were significantly lower (p < 0.05). Stress reduction for POFI scores greater than one week proved to be non-significant (p = 0.099). CONCLUSION: In this study, MSDD was effective at reducing pain and stress experienced with local regional analgesic injections.     

Augmentation of narrow ridges for implants rehabilitation--a review

The quantity of alveolar bone decreases mainly because of periodontal disease or loss of teeth causing bone resorption in both vertical and horizontal directions. Inadequate width of the alveolar ridge affects many parameters of implants placement and the final restoration. Placement of an implant in a narrow ridge without bone graft may harm the final esthetics and the long-term success of the implant rehabilitation. The purpose of this article is to review the basic principles of bone grafting and to discuss various grafting techniques for widening of the narrow ridge.     

1354 freshmen's dental investigation]

1354 freshmen have been investigated to discover the relationship between dental diseases and environments,living habits and personal sanitary conditions,because urban young men like sweet foods and snacks,the incidence of caries is greater in the cities than in the country,more people with tetracycline discolored tooth live in urban areas than in the rustic ones,which is due to dense living conditions, vulnerable to respiratory organs disease,medical conditions and convenience of taking tetracycline when ill;on the other hand,gingivitis is more common within the country students than within the city students,for those students from the country are used to brush their tooth after adolescence and usually have more dental calculus which is harmful to the gingiva.More than half of the investigated freshmen are ignorant of correct method of brushing and oral health and that is important factors of high rate of dental disease,according to the above reasons,the effective measures should educated to prevent dental disease.     

Immunocytochemical localization of growth hormone receptor in rat maxillary teeth.

To address the question of what role growth hormone may have in stimulating tooth formation, the distribution of its receptor/binding protein in developing rat incisors and molars was studied immunocytochemically using well-characterized monoclonal antibodies. Ten female 45-day-old Wistar rats were perfused with 4% paraformaldehyde. Five-microns paraffin sections of the growing end of maxillary incisors and molars were cut, deparaffinized and incubated with mouse anti-growth hormone receptor antibodies or control antibodies. A three-layer streptavidin peroxidase technique was used to detect bound antibody. Immunoreaction product was associated primarily with the cytoplasm of cells at certain stages of differentiation. Dividing cells, differentiating preameloblasts and preodontoblasts, secretory ameloblasts and odontoblasts showed immunoreactivity. Undifferentiated dental epithelium cells, stellate reticulum, external dental epithelial cells, mature odontoblasts, and most of cells in the dental papilla were non-reactive. However, at certain stages of tooth development, the stratum intermedium and the external dental epithelium also stained positively. The presence of growth hormone receptor/binding protein in tooth cells at different stages of their development indicates that growth hormone may influence cell proliferation, differentiation and differentiated functions of ameloblasts, odontoblasts and cementoblasts independent of a systemic mediator, and thus may be involved in stimulating odontogenesis directly.     

Latency of the jaw-opening reflex in the premature, preweaning and adolescent pig (hanford strain miniature pig, Sus scrofa)

The jaw-opening (digastric) reflex was elicited by electrical stimulation of oral mucosa in miniature pigs (Sus scrofa) varying in age from 5 days premature to 101 days post-term. The latency of reflex electromyographic activity varied between 12–14 ms in the most immature animals and 9–11 ms in the oldest animals. The very long-latency digastric responses found in the immature young of nesting mammals were not seen in the relatively precocious young of this species.     

Lactate dehydrogenase isoenzymes in human radicular cysts

Lactate dehydrogenase (LDH) isoenzymes of 15 clinically dormant radicular cysts were examined. A fragment from each cyst was homogenized, centrifuged and the LDH isoenzymes in the supernatant were separated by cellulose acetate paper electrophoresis. The strongest bands of the cysts were LDH-5 and LDH-4.     

Activation of vanilloid receptor 1 (VR1) by eugenol

The structural similarity of eugenol with capsaicin suggests that these two agents may share molecular mechanisms to produce their effects. We investigated the effects of eugenol in comparison with those of capsaicin using whole-cell patch clamp and Fura-2-based calcium-imaging techniques in a heterologous expression system and with sensory neurons. In vanilloid receptor 1 (VR1)-expressing human embryonic kidney (HEK) 293 cells and trigeminal ganglion (TG) neurons, eugenol activated inward currents, whereas capsazepine, a competitive VR antagonist, and ruthenium red (RR), a functional VR antagonist, completely blocked eugenol-induced inward currents. Moreover, eugenol caused elevation of [Ca(2+)](i), and this was completely abolished by both capsazepine and ruthenium red in VR1-expressing HEK 293 cells and TG neurons. Our results provide strong evidence that eugenol produces its effects, at least in part, via VR1 expressed by the sensory nerve endings in the teeth.     

Compositional analysis of human acquired enamel pellicle by mass spectrometry

Relatively little is known about the formation of the acquired enamel pellicle other than that it involves the selective adsorption of specific proteins from oral fluids. Previous studies on the identification of pellicle components have relied largely on immunological or enzymatic detection and have been hampered by the fact that only minute quantities of pellicle can be removed from tooth surfaces. The present work describes an improved method of harvesting pellicle that combines mechanical and chemical removal; this approach was used to investigate systematically the desorption of in vitro pellicle components with different solutions. Eleven major in vitro pellicle proteins were identified by using a combination of electrophoretic separation and matrix-assisted laser desorption/ionization-reflectron time-of-flight mass spectrometry. A similar analysis of in vivo-formed pellicle revealed the presence of intact statherin, lysozyme, albumin and amylase. Further analysis of in vivo pellicle by liquid chromatography-electrospray ionization mass spectrometry suggested the presence of numerous low molecular-weight fragments of precursor proteins. The protein composition of in vitro whole-salivary pellicle adsorbed to hydroxyapatite and that of in vivo enamel pellicle differed for proline, the result of a reduction in the content of acidic proline-rich proteins in the in vivo samples. Unique features of the oral environment such as enzymatic activities or mineral surface properties may account for these differences between in vivo and in vitro pellicle formation.     

Bone regeneration around an osseointegrated implant. A simultaneous approach in a fenestrated defect: a case report.

The use of a barrier membrane, with or without osseous allograft, has been shown to establish regeneration of osseous tissue around dental implants. Following three episodes of persistent symptomatic failed apicoectomy and subsequent tooth extraction, an osseointegrated implant was placed in a wide fenestrated defect. Demineralized freeze-dried bone allograft was covered by an occlusive expanded polytetrafluorethylene membrane. The reentry procedure revealed complete bone fill that followed the texture of the augmentation material beyond the previous buccal bony envelope.