RESUMEN
OBJECTIVES: This study compared the pain response of a group of 40 volunteers to the Wand with the response to syringe injections. STUDY DESIGN: Of 240 total injections given, 120 were with the Wand system, and 120 were with the traditional aspirating syringe. Three injections were evaluated: injections to the middle superior alveolar (MSA) of the maxillary right first premolar and the maxillary left first premolar; palatal injections of the maxillary right first premolar and the maxillary left first premolar; and inferior alveolar nerve injection (IAN) of both the right and the left sides. Each volunteer received 6 injections, 3 on one side with the Wand and 3 on the opposite side with the syringe (control). All injections were given by the primary investigator without the use of a topical anesthetic. Pain perception levels were recorded with a 4-point visual analog scale: no pain, mild pain, moderate pain, and severe pain. The results were evaluated statistically by using an unpaired t test. RESULTS: The results showed injections with the syringe were statistically more painful than injections with the Wand in 4 of 18 evaluations: MSA of the maxillary left first premolar, female volunteers responses to MSA of the maxillary left first premolar, IAN left side injections, and male responses to IAN left injections (P =.01, P =.05, P =.05 and P =.05, respectively). CONCLUSIONS: The Wand generally seemed to provide less painful injections; however, the mean ratings of pain were mostly mild pain for both injections. Therefore, the clinical significance of the results should be interpreted with caution. The operator technique and tactile skill in syringe injections and site of injection (right or left) could be important factors that were not evaluated in this study.
Asunto(s)
Inyecciones/efectos adversos , Dolor/etiología , Jeringas/efectos adversos , Adulto , Anestésicos Locales/administración & dosificación , Femenino , Humanos , Inyecciones/instrumentación , Inyecciones/estadística & datos numéricos , Masculino , Nervio Mandibular , Nervio Maxilar , Mepivacaína/administración & dosificación , Dolor/diagnóstico , Dimensión del Dolor/métodos , Dimensión del Dolor/estadística & datos numéricos , Paladar Blando , Distribución Aleatoria , Estudiantes de Odontología , Jeringas/estadística & datos numéricosRESUMEN
A comparison of the microleakage of mineral trioxide aggregate (MTA) and a high copper admix amalgam (Valiant PhD) in root-end preparations was made using a fluid conductive device. Thirty-three bilaterally matched pairs of extracted, single-rooted teeth were prepared and obturated using lateral compaction of gutta-percha. The root-ends were resected and 3-mm-deep class I cavity preparations were made. The root-end preparations were filled with either amalgam or MTA. Guttapercha coronal to the root-end fillings was removed leaving only the amalgam or MTA present as a barrier to fluid movement. In the fluid-conductive device, the root canals were filled with a phosphate-buffered saline solution at a pressure of 10 psi. The flow of fluid was measured and compared at 1, 2, 3, 4, 8, 12, 16, 20, and 24 wk. The results showed amalgam to have significantly higher microleakage after 4 wk and higher variability compared with the MTA group.
Asunto(s)
Filtración Dental , Obturación Retrógrada , Materiales de Obturación del Conducto Radicular , Compuestos de Aluminio , Análisis de Varianza , Compuestos de Calcio , Aleaciones Dentales , Amalgama Dental , Combinación de Medicamentos , Humanos , Estudios Longitudinales , Óxidos , Reología , SilicatosRESUMEN
An unusual presentation of calcaneal osteomyelitis is described, where-by the infection remained undiagnosed for 25 years. The 36-year-old patient recently sought medical treatment for a reported ankle sprain, but the pain was recalcitrant to conservative care. Further investigation yielded a history significant for stepping on a chicken bone as a child, which entered the inferior lateral heel. Magnetic resonance imaging revealed what plain radiographs did not: a well demarcated lytic lesion in the body of the calcaneus. Intraoperative findings were consistent with an abscess of chronic osteomyelitis. The treatment included incision and drainage, antibiotic beads, and a tricortical bone graft.
Asunto(s)
Calcáneo , Cuerpos Extraños/complicaciones , Talón , Osteomielitis/etiología , Adulto , Animales , Huesos , Calcáneo/cirugía , Pollos , Enfermedad Crónica , Femenino , Humanos , Imagen por Resonancia Magnética , Osteomielitis/diagnóstico , Osteomielitis/terapia , Infecciones por Serratia/diagnóstico , Infecciones por Serratia/etiología , Infecciones por Serratia/terapia , Serratia marcescens/aislamiento & purificación , Factores de TiempoRESUMEN
The number of patients with HIV (human immunodeficiency virus) and AIDS (acquired immune deficiency syndrome) has increased to the point that every podiatric physician in this country will be treating patients who are HIV positive, knowingly or not. Podiatric physicians continue to be part of the medical team that must bear responsibility for the rapid changes in HIV education. Attention must be focused on educating physicians about all aspects of this disease, especially the primary and secondary diseases of AIDS and new treatments and their side effects. Sterile technique and universal precautions have now taken on new importance.
Asunto(s)
Enfermedades del Pie/complicaciones , Infecciones por VIH/complicaciones , Podiatría , Síndrome de Inmunodeficiencia Adquirida/complicaciones , Síndrome de Inmunodeficiencia Adquirida/terapia , Adulto , Enfermedades del Pie/terapia , Infecciones por VIH/terapia , Humanos , Masculino , Persona de Mediana Edad , Podiatría/normas , Podiatría/tendenciasRESUMEN
The microleakage after retrofillings of amalgam, amalgam with cavity varnish, silver-containing glass ionomer cement, and intermediate restorative material was compared in vitro. Thirty-six extracted human incisors and canines were instrumented, obturated with gutta-percha without sealer, subjected to apicoectomy, and retrofilled with the materials described above. After removal of the gutta-percha filling, the microleakage from both directions (apically and coronally) was measured quantitatively and longitudinally for 24 wk after filling by a fluid filtration technique. All four retrofilling materials revealed some apical and coronal leakage at all time periods. The amalgam group showed statistically significant (p less than 0.001) apical leakage at 1.5 h. The use of cavity varnish significantly reduced the apical leakage of the amalgam group at 1.5 h. The silver-containing glass ionomer cement and intermediate restorative material groups showed significantly (p less than 0.05) less coronal leakage compared with the amalgam group at 1.5 h. Scanning electron microscopy of selected samples showed marginal defects of approximately 5 microns between the root dentin and the retrofilling material.
Asunto(s)
Filtración Dental , Obturación Retrógrada , Materiales de Obturación del Conducto Radicular , Cemento de Óxido de Zinc-Eugenol , Cementos Cermet , Amalgama Dental , Recubrimiento de la Cavidad Dental , Materiales Dentales , Dentina/ultraestructura , Eugenol , Filtración , Humanos , Metilmetacrilatos , Microscopía Electrónica de Rastreo , Resinas de Plantas , Óxido de ZincRESUMEN
Retrograde amalgam fillings were placed in 12 extracted human canines. The microleakage from the both directions (coronally and apically) was determined using pressurized fluid filtration at 90 min, 6 h, 1 day, 2 days, and 1,2,4, and 8 wk after amalgam filling. Leakage from either direction decreased markedly in the 90-min to 6-h interval after filling. At intervals between 1 day and 8 wk, only small changes in leakage were noted. After any time period, leakage from the coronal direction was greater than leakage from the apical direction. However, this difference was not statistically significant except at 90 min when the coronal leakage was significantly greater. This experimental system was shown to reliably measure microleakage in retrograde amalgam fillings.