Top Dental Elf Blogs Oct – Dec 2019

The Dental Elf brings you daily updates of evidence-based dentistry research

In October, November and December out most popular blogs were on Molar Incisor Hypomineralisation, local anaesthesia for root canal treatment and long or short dental implants fro restoration of the posterior jaw.

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Computerised local anaesthesia in paediatric patients

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This review ofwhether local computerised anaesthesia decreases the pain and disruptive behaviour in children when compared to conventional anaesthesia included 20 RCTs and suggested no diference between the two approaches.

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Articaine: Is it the best local anaesthetic for teeth with irreversible pulpitis undergoing root canal treatment?

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5 systematic reviews were included in this umbrella review of whether articaine or lidocaine is the most appropriate local anaesthetic solution for teeth with irreversible pulpitis undergoing root canal treatment.

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Articaine or Lidocaine for third molar removal?

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This review of anaesthetic efficiency of articaine for lower third molar extraction included 9 RCTs ( 493 patients -770 lower molars). The findings suggest that 4% articaine with 1:100,000 epinephrine possesses superior anaesthetic efficiency relative to lidocaine.

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Local anaesthetics for preventing pain during dental treatment

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123 RCTs were included in this Cochrane review of local anaesthetic agents for preventing pain during dental treatment. 14 types of local anaesthetic were included evidence to support the use of one over another was limited so further research is needed to clarify the effectiveness and safety of one local anaesthetic over another.

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Articaine: is it more effective than lidocaine in paediatric dentistry?

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This review comparing articaine and lidocaine for local anesthesia use in children only identified 6 low quality studies. Little difference was seen between the two agents.

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Buffering local anaesthetics to reduce dental injection pain?

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14 RCTs were included in this review of the effect of buffering local anaesthetics in reducing infiltration pain and anaesthesia onset time in dentistry. While slight reductions in onset time was seen in inflamed tissues and for IAN block these were not considered to be clinically significant. However the overall quality of the evidence was low.

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Articaine better than lidocaine for supplementary infiltration after mandibular block anaesthesia

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10 studies involving 746 adult patients were included in this review comparing articaine and lidocaine in patients with symptomatic irreversible pulpitis. Articaine was as effective as lidocaine and provided better supplementary infiltration after mandibular block but no other advantages.

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Inferior alveolar nerve block: mepivacaine-lidocaine no better than lidocaine alone suggests trial

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This well conducted and reported trial found that there was no difference between 3% mepivacaine & 2% lidocaine with 1:100,000 epinephrine and 2 cartridges of 2% lidocaine with 1:100,000 epinephrine in terms of injection pain, onset time, and pulpal anesthetic success for the IAN block.

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Lidocaine: trial suggests that buffering may not improve success of inferior alveolar nerve block

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A 2010 Cochrane review that was not able to include any dental studies did find that buffering lidocaine decreased pain on injection and augmented patient comfort and satisfaction. This new dental trial included 80 patients with symptomatic irreversible pulpitis but found no significant difference with success rates with buffered lidocaine.

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