Effect of fentanyl on the success of inferior alveolar nerve block for teeth with symptomatic irreversible pulpitis: a randomized clinical trial

Aim: The purpose of this prospective, randomized, double-blind study was to evaluate the effect of adding fentanyl to lidocaine 2% with epinephrine 1:80,000 on the success of the inferior alveolar nerve block in mandibular molar teeth with symptomatic irreversible pulpitis. Methodology: 100 healthy adult patients with diagnosis of symptomatic irreversible pulpitis in one of the mandibular molar tooth were selected and randomly divided in two groups of 50 patients each. In the first group (fentanyl group), 0.25 ml of a cartridge of 1.8 ml of 2% lidocaine with 1:80,000 epinephrine solution was drained and the same amount from 50μg/ ml fentanyl solution was added to the cartridge. In the second group (non-fentanyl group) 0.25 ml of a cartridge of 1.8 ml of 2% lidocaine with 1:80,000 epinephrine solution was drained and the same amount from saline solution was added to the cartridge. Each group received two cartridges of prepared soloution with inferior alveolar nerve block injection technique. Access cavity preparation started 15 minautes after injection and after confirming the lip numbness. Success defined as no pain or mild pain on the basis of Heft-Parker visual analog scale during access cavity preparation or initial instrumentation. Data were analyzed by T-test and Chi-square Results: The success rate of inferior alveolar nerve block injection was 58% for Fentanyl group and 46% for Non-Fentanyl group. There was no significant difference between the two groups (P=0.23). Conclusions: The addition of fentanyl to lidocaine 2% with epinephrine 1:80,000 did not increase the success rate of the inferior alveolar nerve block in mandibular molar teeth with symptomatic irreversible pulpitis

Impact of Bioresorbable Scaffold Design Characteristics on Local Hemodynamic Forces - An Ex Vivo Assessment With Computational Fluid Dynamics Simulations

AIMS:Bioresorbable scaffold (BRS) regions exposed to flow recirculation, low time-averaged wall shear stress (TAWSS) and high oscillatory shear index (OSI) develop increased neointima tissue. We investigated haemodynamic features in four different BRSs. METHODS AND RESULTS: Fantom (strut height [SH] = 125 µm), Fantom Encore (SH = 98 µm), Absorb (SH = 157 µm) and Magmaris (SH = 150 µm) BRSs were deployed in phantom tubes and imaged with microCT. Both 2D and 3D geometrical scaffold models were reconstructed. Computational fluid dynamics (CFD) simulation was performed to compute TAWSS and OSI. Thicker struts had larger recirculation zones and lower TAWSS in 2D. Absorb had the largest recirculation zone and the lowest TAWSS (240 µm and −0.18 Pa), followed by Magmaris (170 µm and −0.15 Pa), Fantom (140 µm and −0.14 Pa) and Fantom Encore (100 µm and −0.13 Pa). Besides strut size, stent design played a dominant role in 3D. The highest percentage area adverse TAWSS (0.2) were found for Fantom (56% and 30%) and Absorb (53% and 33%), followed by Fantom Encore (30% and 25%) and Magmaris (25% and 20%). Magmaris had the smallest areas due to a small footprint and rounded struts. CONCLUSIONS: Due to stent design, both Fantom Encore and Magmaris showed smaller TAWSS and OSI than Fantom and Absorb. This study quantifies which scaffold features are most important to reduce long-term restenosis

Impact of Bioresorbable Scaffold Design Characteristics on Local Hemodynamic Forces - An Ex Vivo Assessment With Computational Fluid Dynamics Simulations

AIMS:Bioresorbable scaffold (BRS) regions exposed to flow recirculation, low time-averaged wall shear stress (TAWSS) and high oscillatory shear index (OSI) develop increased neointima tissue. We investigated haemodynamic features in four different BRSs. METHODS AND RESULTS: Fantom (strut height [SH] = 125 µm), Fantom Encore (SH = 98 µm), Absorb (SH = 157 µm) and Magmaris (SH = 150 µm) BRSs were deployed in phantom tubes and imaged with microCT. Both 2D and 3D geometrical scaffold models were reconstructed. Computational fluid dynamics (CFD) simulation was performed to compute TAWSS and OSI. Thicker struts had larger recirculation zones and lower TAWSS in 2D. Absorb had the largest recirculation zone and the lowest TAWSS (240 µm and −0.18 Pa), followed by Magmaris (170 µm and −0.15 Pa), Fantom (140 µm and −0.14 Pa) and Fantom Encore (100 µm and −0.13 Pa). Besides strut size, stent design played a dominant role in 3D. The highest percentage area adverse TAWSS (0.2) were found for Fantom (56% and 30%) and Absorb (53% and 33%), followed by Fantom Encore (30% and 25%) and Magmaris (25% and 20%). Magmaris had the smallest areas due to a small footprint and rounded struts. CONCLUSIONS: Due to stent design, both Fantom Encore and Magmaris showed smaller TAWSS and OSI than Fantom and Absorb. This study quantifies which scaffold features are most important to reduce long-term restenosis