Adrian Cowan

Clinical assessment of a new local anesthetic agent—carticaine

The combination of 4 per cent carticaine 5 mug per milliliter with epinephrine is an effective agent acting in the standard lidocaine-epinephrine-mepivacaine-epinephrine range. Like lidocaine, it is of no clinical value without the addition of epinephrine and its vasodilator properties are greater than those of mepivacaine or prilocaine. Its onset time is reasonably rapid, its duration and extent are satisfactory for clinical purposes, and no toxic reactions were noted in the 100 injections given. However, its predictability for +4 anesthesia is poor, and there is wide variation in the onset time. Finally, the success rate compared with that for lidocaine, mepivacaine, or prilocaine for the same dosage and areas, with the use of the same criteria, is not good enough in my opinion to qualify carticaine as a general-purpose anesthetic on a par with standard lidocaine.

Further clinical evaluation of prilocaine (Citanest), with and without epinephrine.

Abstract 1. 1. A review of a series of 1,438 injections involving prilocaine in concentrations of from 2 to 4 per cent, with and without epinephrine, is presented. 2. 2. The improvement in prilocaines effectiveness as the epinephrine content is lowered is described. 3. 3. The difference between “known” and “double-blind” testing for local anesthetics is discussed. 4. 4. Four per cent prilocaine alone is rated a safe, nontoxic solution of ultrashort duration; four per cent prilocaine with epinephrine 1 300,000 compares favorably with standard lidocaine, but with shorter duration (2 hours). The possibility of occasional mild dizziness in about 2 per cent of the patients in whom this solution was used is mentioned.

Leontiasis ossea: Report of a case

Abstract 1. 1. A case of leontiasis ossea which was primarily investigated as a result of oral findings is presented. 2. 2. There are present atypical features which leave the diagnosis between the pathologic entity described as leontiasis ossea and the clinical appearance known as leontiasis ossea the latter of which may be due to a number of underlying causes. 3. 3. In this case, Pagets disease is suggested as the underlying cause, for biopsy and blood findings compatible with Pagets disease are present. If this is so, the case is of interest as the patient is the youngest that I have been able to find reported in the literature. 4. 4. Roentgenographic features and facial and dental findings typical of the pathologic entity known as leontiasis ossea are also present. 5. 5. A survey of some of the relevant literature is included.

Clinical Evaluation of a New Anesthetic Agent, L67

Rapid-acting modern anesthetics of the lignocaine group have one disadvantage from the standpoint of the ordinary dental patient in that their effects are prolonged greatly beyond the operating time, usually for about 3 hours. It is possible, by reducing the dose in certain areas of the mouth to as little as 0.25 ml., to shorten the duration considerably. These areas are limited however and in an effort to overcome this deficiency, a new anesthetic agent, L67 (a n-propylamino-2-methylpropionanilide), which is related to lignocaine, has been produced. The purpose of this investigation was to assess this new agent clinically and also to observe the effects of 2 per cent lignocaine with greatly reduced adrenalin content.

The influence of vitamin C on the periodontal membrane space-A radiographic study.

SummaryOne of the findings in experimentally induced scurvy has been an irregularity of the periodontal membrane shadow in radiographs. A similar irregularity has been described in relation to early periodontal disease. This study investigated the effect of high dosage vitamin C on a group of young (average age 29) patients drawn at random from practice. Areas of irregularity in the membrane shadow have shown an improvement of outline in a significant number of treated cases as compared with controls in a double blind investigation and the author suggests that this represents a consolidation of the collagen element of the membrane with possible increased resistance to disease.A special holder was used to facilitate duplication of the position of the pre and post therapy films and examples are shown.

Continuing education: A survey of the attitudes of the dental profession in Ireland

SummaryA survey of the attitude of dental surgeons in the Republic of Ireland to continuing education was carried out by means of a Questionnaire. Replies were received from 21 per cent of the dentists in the Republic and the questions covered qualifications; methods of keeping in touch with current knowledge and of revising previous knowledge; journals taken; attendances at lectures, group discussion and courses; opinions on courses required, on the correlation of courses and on the types of courses. It was clear that there was considerable interest in continuing education but most experience (86 per cent) over a three year period had been confined to occasional scientific meetings and group discussions. The numbers attending authentic courses decreased (51–23 per cent) in proportion to the length of the courses. Motivations and incentives were also considered.

The influence of fucidin on the healing of extraction wounds in dogs

Summary1.A series of surgical extractions has been carried out on the teeth of dogs under aseptic condition.2.Comparison has been made clinically and histologically between the rate of healing of sockets into which fucidin had been introduced in powder form and that in control sockets. Biopsies were taken at seven, 14 and 21 days.3.A further group of sockets was examined for the effects of introducing fucidin seven and 14 days after extraction.4.The tentative conclusion is that fucidin does favourably influence the rate of healing. The maximum improvement appears to occur when the drug is mixed with blood clot immediately after extraction, and to a lesser degree when it is added later—the longer the interval the less the effect.5.It is stressed that these results are only indicators, and that a further clinical and experimental trial is necessary for proven conclusions.