ORAL SURGERY ABSTRACTS
THE EFFECTIVENESS OF ELECTRONIC PULSED SOFT TISSUE VIBRATION COMPARED WITH TOPICAL ANAESTHESIA IN REDUCING THE PAIN OF INJECTION OF LOCAL ANAESTHETICS IN ADULTS: A RANDOMIZED CONTROLLED SPLIT-MOUTH CLINICAL TRIAL Salma RG, Alsayeh A, et. al. Int J Oral Maxillofac Surg July 2020. doi: 10.1016/j.ijom.2020.07.010 Administration of local anesthesia is a critical step in performing any dentoalveolar procedure and tends to be a significant source of patient anxiety. Once effective analgesia is obtained, the majority of patients tend to tolerate treatment without issue. For optimizing patient care and subjective experience throughout the process of local administration, several techniques have been previously investigated. These include topical anesthetics, cryoanesthesia, laser treatment, TENS (transcutaneous electric nerve stimulation), tissue vibration, hypnosis, buffering local solutions, and nitrous oxide among others. As vibration devices have been minimally researched, this study aimed to compare pain during needle insertion and solution infiltration when using a vibration device as compared
to topical anesthetic. A prospective randomized controlled clinical trial was performed on patients at the Riyadh Elm University Dental Hospital using a split-mouth design. All patients were 18 years of age or more, ASA class I, pain free, had received dental local anesthetic in the past, and were indicated for bilateral same-jaw posterior extractions. The patients underwent local injections with subsequent exodontia across two visits, one of which was performed after 2 minutes application of topical benzocaine, while the other side was administered with hand-held vibration device (DentalVibe) without topical. A total of 332 injections were given to 166 patients. Pain of penetration and mid-injection pain were measured using visualized analogue scale. Changes in heart rate during penetration and during
injection were measured using pulse oximetry. Median pain scores were about 43% less at penetration and 67% less during infiltration with use of the vibration device compared to topical anesthesia. Heart rate change was 43% lower for insertion and 33% lower for injection with use of the vibration device. Stimulation of mechanoreceptors via vibration leads to transmission of signals through large Aβ fibers which may suppress afferent activity from small Aδ and C fibers responsible for transmission of pain as explained by the gate-control theory. Vibration devices may be an effective means to improve patient comfort during administration of local anesthesia.
Sean Eccles, DDS; Resident, Oral and Maxillofacial Surgery, VCU Medical Center
DENTAL IMPLANT PLACEMENT IN ALVEOLAR CLEFT PATIENTS: A RETROSPECTIVE COMPARATIVE STUDY ON CLINICAL AND AESTHETIC OUTCOMES Alberga JM et al. Int J Oral Maxillofac Surg. 2020; 49(7): 952-959 The alveolar cleft patient is a unique type of patient for anyone in dentistry to treat. Their development and anatomy offer unique challenges for every specialty in dentistry. Alveolar clefts are typically reconstructed between the ages of 7-11 with autogenous bone graft, but an edentulous defect usually remains. The aim of this retrospective study was to
40
assess clinical and aesthetic outcomes and patient satisfaction following implant placement in cleft patients. Patients were evaluated from a period of 2001 to 2016. Seventeen cleft patients were evaluated alongside 17 control non-cleft patients receiving implants at the same site. Controls that required bone grafting prior to implant placement were selected to
match the operated site of cleft patients. Age could not be matched. After implant placement, the authors compared plaque index, bleeding index, probing pocket depth, marginal bone level changes, pink aesthetic score of gingiva and overall patient satisfaction with treatment. Of these values, only bleeding upon probing and presence of plaque occurred more
>
