Incidence of positive blood aspiration following inferior alveolar nerve block

Aim or Purpose: To compare the incidence of positive blood aspiration into the dental anesthetic cartridge between the non-aspirating dental syringe and the aspirating dental syringe following inferior alveolar nerve block. Materials and Methods: [DESIGN: Randomized Controlled Trial. (Trial Registration: TCTR 20190727001)]. One thousand and twenty-six patients, who need inferior alveolar nerve block before dental surgical procedure, were randomly included in the study. Block randomization was used to select either non-aspirating dental syringe or aspirating dental syringe (right side or left side). All patients were anesthetized with the same type of dental needle, the same type of local anesthetic agent by the same surgeon. Observation of positive or negative blood aspiration into the dental anesthetic cartridge. Comparing of the systolic blood pressure, diastolic blood pressure and pulse rate both pre-injection and immediately post-injection using the same digital blood pressure monitor. Results: Positive blood aspiration in the non-aspirating dental syringe group (11.3 %) was statistically significant less than positive blood aspiration in the aspirating dental syringe group (19.1 %) (p=0.001). There was no statistically significant difference between the pre-injection and immediately post-injection systolic blood pressure and pulse rate. Although the pre-injection and immediately post-injection diastolic blood pressure was statistically significant difference, it was not clinically difference. Conclusions: The non-aspirating dental syringe can be used to give local anesthetic agent with inferior alveolar never block

Periodontal disease and FAM20A mutations

Enamel-renal-gingival syndrome (ERGS; OMIM #204690), a rare autosomal recessive disorder caused by mutations in FAM20A, is characterized by nephrocalcinosis, nephrolithiasis, amelogenesis imperfecta, hypoplastic type, gingival fibromatosis and other dental abnormalities, including hypodontia and unerupted teeth with large dental follicles. We report three patients and their families with findings suggestive of ERGS. Mutation analysis of FAM20A was performed in all patients and their family members. Patients with homozygous frameshift and compound heterozygous mutations in FAM20A had typical clinical findings along with periodontitis. The other had a novel homozygous missense mutation in exon 10, mild gingival fibromatosis and renal calcifications. The periodontitis in our patients may be a syndrome component, and similar findings in previous reports suggest more than coincidence. Fam20a is an allosteric activator that increases Fam20c kinase activity. It is hypothesized that lack of FAM20A activation of FAM20C in our patients with FAM20A mutations might have caused amelogenesis imperfecta, abnormal bone remodeling and periodontitis. Nephrocalcinosis appears not to be a consistent finding of the syndrome and the missense mutation may correlate with mild gingival fibromatosis. Here we report three patients with homozygous or compound heterozygous mutations in FAM20A and findings that extend the phenotypic spectrum of this disorder, showing that protein truncation is associated with greater clinical severity