Anesthetic Efficacy of Inferior Alveolar Nerve Block: Conventional versus Akinosi Technique

Objective: Anesthetic techniques like the Akinosi technique were introduced to surmount the problems of the conventional inferior alveolar nerve block (IANB) technique. This study aimed to compare the local anesthetic efficacy of IANB via the conventional and Akinosi techniques in patients presenting to the Maxillofacial Surgery Department of School of Dentistry, Shahid Beheshti University.Methods: This clinical trial was conducted on 80 candidates for bilateral extraction of mandibular molars. For each patient, local anesthesia was induced by IANB injection, which was done by the conventional technique in one side and by the Akinosi technique in the other side of the mouth. The allocation of technique to side was randomized. Time to anesthesia for the long buccal, lingual and inferior alveolar nerves (IAN), degree of pain during injection and tooth extraction and incidence of positive aspiration in the two techniques were evaluated and analyzed using Wilcoxon Signed Rank and Chi square tests.Results: The mean time to anesthesia for the IAN was 2.82 minutes in the conventional and 3.05 minutes for the Akinosi technique. These values were 1.47 and 1.55 minutes, respectively for the lingual nerve and 1.43 and 1.56 minutes, respectively for the long buccal nerve. Four patients in the Akinosi technique and 12 patients in the conventional technique had positive aspiration. During anesthetic injection with the Akinosi technique, 72.5% were pain free, 18.8% experienced mild, 5% experienced moderate and 3.8% experienced severe pain. These values in the conventional technique were 51.3%, 27.5%, 11.3% and 10%, respectively.Conclusion: Considering the lack of a significant difference between the success rate of conventional and Akinosi IANB techniques, Akinosi technique seems to be a suitable alternative to the conventional technique since it is less painful and has lower risk of positive aspiration

Evaluation of impact teeth prevalence and related pathologic lesions in patients in Northern part of Iran (2014-2016)

Objective: In this research, our purpose was to evaluate how prevalent impacted tooth is. We also evaluated the type of third molar impaction and pathologic lesions related to impacted teeth in patients reffered to Sari and Babol dental school in 2014-2016. Methods: The study was cross-sectional, and was carried out on 2109 panoramic radiographs of patients with age over 20 years referring to Sari and Babol dental faculties during 2014-2016. Results: Among the patients, 392 (18.5%) presented with at least one impacted tooth. 243 women (20.6%) and 149 men (16%) had impacted teeth. Conclusion: The most common encountered impact tooth was found to be the third molar of mandible and dentigerous cyst was the most detected lesion associated with tooth impaction

Prevalence of Dry Socket Following Tooth Extraction and Associated Factors

Background and purpose: Dry socket is a limiting complication with unknown etiology and acute inflammation of the alveolar bone in the extracted tooth socket that occurs one to three days after tooth extraction with severe pain due to complete or incomplete destruction of the blood clot. The present study aimed at evaluating the prevalence of dry socket following tooth extraction and its related factors. Materials and methods: This descriptive cross-sectional study was performed in 1199 patients aged 18-60 years in patients attending dental clinics in Sari, Iran, 2018. Patients’ satisfaction were obtained and their demographic and dental information were recorded. Within 48-72 hours after tooth extraction, telephone follow-up was done by 4th and 5th year dental students and senior dentists. Data analysis was conducted using SPSS V24. Results: In this study, the prevalence of dry socket was 1.1%. The most common reason for tooth extraction was extensive tooth decay and third molar was the most frequent tooth extracted (45.4%). According to the analyses, those who did not brush their teeth at all were more likely to experience dry socket. Conclusion: In this study, flap technique with bone extraction and simple method resulted in highest and lowest prevalence of dry socket, respectively

Parallelism of the Occlusal Plane with the Ala-tragus Line in Various Posterior References in Dentate Patients

Background and purpose: Occlusal plane in edentulous patients is lost and needs to be reconstructed. The most common method for reconstructing occlusal plane is to make it parallel to the ala-tragus line. There are disagreements about the posterior reference of ala-tragus line. The aim of this study was to determine the best posterior reference of ala-tragus line (superior, middle and anterior references) for reconstructing occlusal plane. Materials and methods: In this descriptive-analytical study, 150 dentate patients with class I relationship enrolled. Patients were placed 1.5 meters from the camera and their head was in NHP mode and symmetrical to the line perpendicular to the horizon. Fox-plane was placed in contact with central incisors and first molars of maxilla and imaging was performed from the right side of the face. The angles required were then measured using AutoCAD 2020. Results: There were 75 male and 75 female patients (mean age= 23.05±1.69 years) and the mean OT1-OP angle was 8.75, which was the closest to the mean OT1-AT3 angle (8.85). This finding also was repeated in both men and women. Among all patients, OT1-AT3 angle was found to have the highest proximity to the occlusal plane (61. 33%), 53.34% in men and 69.33% in women. Conclusion: Inferior point on the tragus of the ear in ala-tragus is the best reference for reconstructing the occlusal plane during construction of a removable denture for male and female edentulous patients

Comparing Marginal Fit and Marginal Gap between Sholder Bevel and 135° Finish Line Designs in Posterior Metal Ceramic Restoration Crowns

Background and purpose: One of the major challenges for dentists is providing the patients with a crown of appropriate marginal fit and marginal gap. Preparation of a 135° finish line has some advantages such as technical ease and appropriate finish line record. Nevertheless, few studies investigated this type of finish line. The current study aimed at comparing marginal fit and marginal gap in 135° finish line and shoulder bevel finish line. Materials and methods: In this quasi-experiment study, 135° finish line and shoulder bevel finish line were performed in two first mandibular molars with healthy coronal tissue and similar size. Impression was taken from each tooth and 31 crowns were made on each die. Samples plastered with fit checker were pressed under 40 N for three minutes in universal testing machine. They were measured and recorded under a loop with 40x power at three points on each side. To analyze the data, Wilcoxon and Kolmogorov-Smirnov tests were applied in SPSS V24. Results: Mean values for the marginal fit in shoulder bevel and 135° finish line were 55.0907 µ and 55.2587 µ, respectively. The mean values for marginal gap were 19.7245 µ and 0.9745, respectively (P=0.000). Conclusion: According to current study, a 135° finish line may have better clinical efficacy than a shoulder bevel

Evaluating the Distance between Parotid Papilla and Occlusal Plane in Dentate Patients

Background and purpose: Determining the occlusal plane is one of the essential clinical steps in prosthetic treatment. Intraoral landmark of parotid papilla is used as an adjunct in determining the occlusal plan. The aim of this study was to investigate the exact distance between the parotid papilla and the occlusal plane as an additional criterion for determining the occlusal plane. Materials and methods: In this cross-sectional study, the study group consisted of 148 patients aged 18-50 years old including 74 men attending Sari Dental School in 2019. In maximum intercuspation, vertical distance from the parotid papilla site to the occlusal surface of the first molars of the maxilla was measured by a probe. Data analysis was performed applying Mann-Whitney and correlation test. Results: The mean distance (mm) between the parotid papilla and the occlusal plane for the right papilla (R) was 6.16, while for the left papilla (L) it was 6.51 (R=6.47 and L=6.70 in men and R=5.84 and L=6.31 in women).  The distance at both the right and left sides was higher in men (P= 0.009 and P= 0.044, respectively). Significant difference was seen between both sides in the distance which was higher at left side (P= 0.03). Findings showed no significant relationship between age and this distance at right (P= 0.083) and left (P=0.065) sides. Conclusion: The amount of parotid papilla distance to the occlusal plane on both sides was significantly higher in men than that in women. Also, this distance on the left side is significantly higher than the right side. There was no significant relationship between age and the distance stusdied