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OR 69 Anesthetic efficacy of the intraosseous injection as an adjunct in endodontics
2 6 6 @ Journal of Endodontics
Vol. 23, No. 4, April 1997
00~1 °_~L3
Osteoconduction of Calcium Phosphate Thin Film on --OO~1 Immunohistochemical localization of the core protein of Porous Implants in Rabbit. HQ Nguyen*, DA Deporter, decorin in human dentin. RM Pilliar, JE Davies, N Valliquette, g Chernecky M.R.BISHOP*,D.J.CHIEGO JR.,G.N.GLICKMAN. (University of Toronto, Faculty of Dentistry, Canada). The University of Michigan, Ann Arbor. The proteoglycan decorin appears to inhibit crystal enucleation in The application of calcium phosphate (CP) coatings to dental various mineralized tissues. When mineralization commences, implants promises marked improvement in the rapidity of the decorin is believed to be degraded from its binding site within osseointegration. This study compared the healing responses, after 2 weeks of implantation, between porous-coated Ti6A14V the collagen matrix, allowing phosphoproteins to bind and initiate hydroxyapatite crystal formation. The purpose of this project was implants (control) and the same implant design with a submicron to determine qualitatively the spatial localization of decorin in the layer of CP applied to the implant surface by the sol-gel extracellular matrix of primary and secondary, peritubular, technique. In group I, the proximal end of the right tibia in 10 circumpulpal, and reparative dentin after standard cavity rabbits received two transcortical implants, one CP-coated and preparation. 40 teeth from 15 patients undergoing orthodontic one control. In group II, one of each implant type was placed therapy were used. Following Class I cavity preparation in 10 into either the right or left tibia of 6 rabbits. Back scattered SEM teeth, IRM restorations were placed 30 days prior to extraction to and image analyzer were used to measure bone contact length allow for reparative dentin formation. The remaining teeth were (BCL), contact length fraction (CLF), slraight line endosteal randomly selected for evaluation with the contralateral teeth as bone growth (SLBG), area of bone ingrowth (ABG), and bone controls. Teeth were extracted, fixed, demineralized, sectioned density fraction (BDF). The results were submitted to Repeated and immunostained with anti-decorin (LF-30) antibody using Measures ANOVA. In group I, BCL, CLF, & ABG for CPstandard ABC techniques. PDL cells and endothelial cells on each coated implants were significantly greater than conlrol implants section served as positive controls; sections incubated without (p<0.05); however, SLBG & BDF differences were not anti-decorin served as negative controls. Semi-qualitative statistically different. In group II, BCL, CLF & SLBG for the evaluation of samples by 2 calibrated evaluators demonstrated CP-coated group were signifteantly greater than control group that decorin was associated with the mineralization front in and there were no significant differences in the ABG & BDF normal circumpulpal dentin at all levels in teeth with completely values. Freeze fracture SEM analysis (35-1000X) revealed formed apices. In teeth that were traumatized by operative woven bone closely adapted to the neck region of beads for the procedures or had death of the primary odontoblasts, decorin was CP-coated implant with the cement layer dearly visible..,The found at the original mineralization front but was not associated sli~_ht differences between ~rouv I & II su~,ests the need for with the reparative dentin. In the reactionary dentin surrounding furrther investi|,ation includih~ a ihoroup.h clA/actefization of the pulpai lesions, decorin was localized at the mineralization front, sol-eel form coating. Neverflieless. thei'esults d~m'ton,~ated that similar to normal circumpulpal dentin. The results of these a very thin laver-(0.3-0.5um~ of CP may be tamable of studies suggest that decorin is actively involved in the osteoconductiofi and the sol-~el teehnioue of-CP anvl~cation is mineralization of human dentin. This study was supported in part suitable for riotous-coated ir~lant with-out occluding-the pores. by grants from the Foundation of the AAE and the Pankey This study ffas supported by 1VIRCof Canada grant # 11439 and Institute. AAE Foundation.
OO;I
Anesthetic Efficacy of the Intraosseous Injection as an OR[07 ~ The Supplemental Intraosseous Injection of 2% Adjunct in Endodontics. S.A. Parente*, R.W. Anderson, Mepivacaine with 1:20,000 Levonordefrin. A. W.W. Herman, W.F. Kimbrough, and R.N. Weller. GUGLIELMO*, A. READER, R. NIST, M. BECK, J. WEAVER. The Ohio State University, Columbus, OH Medical College of Georgia, Augusta, GA. Many studies have reported less than desirable success rates for The purpose of this study was to determine the anesthetic effective pulpal anesthesia. For endodontists, those anesthetic efficacy and heart rate effects of a suPl~lemental IO injection, failures associated with teeth diagnosed with irreversible pulpitis using the Stabident system, of 2% mepwacaine with 1:20,000 are of particular concern. Various supplemental anesthetic levonordefrin in mandibular first molars. Using a repeatedtechniques have been recommended. The purpose of this study measures design, 40 subjects randomly received 3 combinations of injections at 3 separate appointments spaced at least 2 weeks was to determine the efficacy of the supplemental intraosseous apart: (I) inferior alveolar nerve block ~ using 3~ injection (IOI) of 2 % lidocaine with 1:100,000 epinephrine using mepivae.aine)÷lO injection of 1.8ml of 2% mepwaeaine the Stabident device. In this study, 93 % (28/30) of the patients (1:20,000 levonordefrin); (2) IAN+IO injection of 2% lidocaine exhibiting pulpalgia refractory to conventional methods of local (1:100,000 epinephrine)[positive control]; (3) IAN+mock IO anesthesia presented with symptomatic mandibular posterior injection [negative control]. The 1st molar was blindly tested teeth. All teeth were diagnosed with irreversible pulpitis. Each with an electric pulp tester at 2 min cycles for 60 min. Heart patient had received conventional infiltration or an inferior rate (pulse rate) was recorded, using a Criticare pulse oximeter, at baseline and during and after anesthetic administration. alveolar nerve block in conjunction with long bueeal infiltration, Anesthetic success was defined as no subject reslxmse to the with a minimum of 3.6 ml of 2% lidocaine with 1:100,000 maximum output of the pulp tester (80 reading) within 15 min. epinephrine. Patients who felt pain during endodontic access, and maintenance of this reading for 60 rains. 100% of the received a supplemental IOI using 0.45 to 0.90 ml of 2% subjects had lip numbness. Anesthetic success was statistically lidoeaine with 1:100,000 epinephrine. Modified pain visual significant (p<0.05), as analyzed by McNemar tests, between analogue scales completed by the patients, coupled with operator the IAN+mock IO (50% success) versus the IAN+IO using 2% evaluations were used to measure success. The Stabident IOI me~vacaine with 1evo.(83% success) and the IAlq+lO using 2% was found to be 87% (±6.2) successful as a supplement in iidocaine with epi. (85% success). ANOVA analysis showed an obtaining pulpal anesthesia, enabling completion of endodontic identical increase in heart rate with 2% lidocaine (epi.) and 2% therapy.The 95 % confidence interval was between 73% and mepivacaine 0evo.) during and for 2 min. following IO solution 99%. The results of this study indicated that when conventional deposition. We concluded that 2% mepivacaine with 1:20~000 anesthetic teehnioues failed to anesthetize posterior teeth levonordefrin was identical to 2% lidocaine with l:100~000 diagnosed with irreversible vulDitis, the IOI was an effective epinephrine for supplemental intraosseous anesthesia and the solutions were identical for increases in heart rate. sum~lemental techni0ue.
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Vol. 23, No. 4, April 1997
00~1 °_~L3
Osteoconduction of Calcium Phosphate Thin Film on --OO~1 Immunohistochemical localization of the core protein of Porous Implants in Rabbit. HQ Nguyen*, DA Deporter, decorin in human dentin. RM Pilliar, JE Davies, N Valliquette, g Chernecky M.R.BISHOP*,D.J.CHIEGO JR.,G.N.GLICKMAN. (University of Toronto, Faculty of Dentistry, Canada). The University of Michigan, Ann Arbor. The proteoglycan decorin appears to inhibit crystal enucleation in The application of calcium phosphate (CP) coatings to dental various mineralized tissues. When mineralization commences, implants promises marked improvement in the rapidity of the decorin is believed to be degraded from its binding site within osseointegration. This study compared the healing responses, after 2 weeks of implantation, between porous-coated Ti6A14V the collagen matrix, allowing phosphoproteins to bind and initiate hydroxyapatite crystal formation. The purpose of this project was implants (control) and the same implant design with a submicron to determine qualitatively the spatial localization of decorin in the layer of CP applied to the implant surface by the sol-gel extracellular matrix of primary and secondary, peritubular, technique. In group I, the proximal end of the right tibia in 10 circumpulpal, and reparative dentin after standard cavity rabbits received two transcortical implants, one CP-coated and preparation. 40 teeth from 15 patients undergoing orthodontic one control. In group II, one of each implant type was placed therapy were used. Following Class I cavity preparation in 10 into either the right or left tibia of 6 rabbits. Back scattered SEM teeth, IRM restorations were placed 30 days prior to extraction to and image analyzer were used to measure bone contact length allow for reparative dentin formation. The remaining teeth were (BCL), contact length fraction (CLF), slraight line endosteal randomly selected for evaluation with the contralateral teeth as bone growth (SLBG), area of bone ingrowth (ABG), and bone controls. Teeth were extracted, fixed, demineralized, sectioned density fraction (BDF). The results were submitted to Repeated and immunostained with anti-decorin (LF-30) antibody using Measures ANOVA. In group I, BCL, CLF, & ABG for CPstandard ABC techniques. PDL cells and endothelial cells on each coated implants were significantly greater than conlrol implants section served as positive controls; sections incubated without (p<0.05); however, SLBG & BDF differences were not anti-decorin served as negative controls. Semi-qualitative statistically different. In group II, BCL, CLF & SLBG for the evaluation of samples by 2 calibrated evaluators demonstrated CP-coated group were signifteantly greater than control group that decorin was associated with the mineralization front in and there were no significant differences in the ABG & BDF normal circumpulpal dentin at all levels in teeth with completely values. Freeze fracture SEM analysis (35-1000X) revealed formed apices. In teeth that were traumatized by operative woven bone closely adapted to the neck region of beads for the procedures or had death of the primary odontoblasts, decorin was CP-coated implant with the cement layer dearly visible..,The found at the original mineralization front but was not associated sli~_ht differences between ~rouv I & II su~,ests the need for with the reparative dentin. In the reactionary dentin surrounding furrther investi|,ation includih~ a ihoroup.h clA/actefization of the pulpai lesions, decorin was localized at the mineralization front, sol-eel form coating. Neverflieless. thei'esults d~m'ton,~ated that similar to normal circumpulpal dentin. The results of these a very thin laver-(0.3-0.5um~ of CP may be tamable of studies suggest that decorin is actively involved in the osteoconductiofi and the sol-~el teehnioue of-CP anvl~cation is mineralization of human dentin. This study was supported in part suitable for riotous-coated ir~lant with-out occluding-the pores. by grants from the Foundation of the AAE and the Pankey This study ffas supported by 1VIRCof Canada grant # 11439 and Institute. AAE Foundation.
OO;I
Anesthetic Efficacy of the Intraosseous Injection as an OR[07 ~ The Supplemental Intraosseous Injection of 2% Adjunct in Endodontics. S.A. Parente*, R.W. Anderson, Mepivacaine with 1:20,000 Levonordefrin. A. W.W. Herman, W.F. Kimbrough, and R.N. Weller. GUGLIELMO*, A. READER, R. NIST, M. BECK, J. WEAVER. The Ohio State University, Columbus, OH Medical College of Georgia, Augusta, GA. Many studies have reported less than desirable success rates for The purpose of this study was to determine the anesthetic effective pulpal anesthesia. For endodontists, those anesthetic efficacy and heart rate effects of a suPl~lemental IO injection, failures associated with teeth diagnosed with irreversible pulpitis using the Stabident system, of 2% mepwacaine with 1:20,000 are of particular concern. Various supplemental anesthetic levonordefrin in mandibular first molars. Using a repeatedtechniques have been recommended. The purpose of this study measures design, 40 subjects randomly received 3 combinations of injections at 3 separate appointments spaced at least 2 weeks was to determine the efficacy of the supplemental intraosseous apart: (I) inferior alveolar nerve block ~ using 3~ injection (IOI) of 2 % lidocaine with 1:100,000 epinephrine using mepivae.aine)÷lO injection of 1.8ml of 2% mepwaeaine the Stabident device. In this study, 93 % (28/30) of the patients (1:20,000 levonordefrin); (2) IAN+IO injection of 2% lidocaine exhibiting pulpalgia refractory to conventional methods of local (1:100,000 epinephrine)[positive control]; (3) IAN+mock IO anesthesia presented with symptomatic mandibular posterior injection [negative control]. The 1st molar was blindly tested teeth. All teeth were diagnosed with irreversible pulpitis. Each with an electric pulp tester at 2 min cycles for 60 min. Heart patient had received conventional infiltration or an inferior rate (pulse rate) was recorded, using a Criticare pulse oximeter, at baseline and during and after anesthetic administration. alveolar nerve block in conjunction with long bueeal infiltration, Anesthetic success was defined as no subject reslxmse to the with a minimum of 3.6 ml of 2% lidocaine with 1:100,000 maximum output of the pulp tester (80 reading) within 15 min. epinephrine. Patients who felt pain during endodontic access, and maintenance of this reading for 60 rains. 100% of the received a supplemental IOI using 0.45 to 0.90 ml of 2% subjects had lip numbness. Anesthetic success was statistically lidoeaine with 1:100,000 epinephrine. Modified pain visual significant (p<0.05), as analyzed by McNemar tests, between analogue scales completed by the patients, coupled with operator the IAN+mock IO (50% success) versus the IAN+IO using 2% evaluations were used to measure success. The Stabident IOI me~vacaine with 1evo.(83% success) and the IAlq+lO using 2% was found to be 87% (±6.2) successful as a supplement in iidocaine with epi. (85% success). ANOVA analysis showed an obtaining pulpal anesthesia, enabling completion of endodontic identical increase in heart rate with 2% lidocaine (epi.) and 2% therapy.The 95 % confidence interval was between 73% and mepivacaine 0evo.) during and for 2 min. following IO solution 99%. The results of this study indicated that when conventional deposition. We concluded that 2% mepivacaine with 1:20~000 anesthetic teehnioues failed to anesthetize posterior teeth levonordefrin was identical to 2% lidocaine with l:100~000 diagnosed with irreversible vulDitis, the IOI was an effective epinephrine for supplemental intraosseous anesthesia and the solutions were identical for increases in heart rate. sum~lemental techni0ue.
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