Douglas M. Barnes

Computerized local dental anesthetic systems: patient and dentist satisfaction

Abstract A computer controlled dental anesthetic delivery system was studied with the Objective of evaluating and comparing the unit to the traditional method of anesthetic delivery. The research design and Method of study involved the use of trained dentists who used both types of delivery systems on patients seen during their routine practice of dentistry. After the dental appointment was finished each dentist completed a survey concerning the injection. Patients completed a survey before the injection concerning their previous anesthetic experiences and completed another survey at the end of the dental appointment concerning the injection they had just received. Statistical analyses yielded Results showing the two methods were rated very similarly by both patients and dentists. Conclusions resulting from the study are that computer controlled dental anesthetic injections and traditional anesthetic injections were accepted equally well by both dentists and patients.

Double-masked, randomized, placebo-controlled study to evaluate the efficacy and tolerability of intranasal K305 (3% tetracaine plus 0.05% oxymetazoline) in anesthetizing maxillary teeth

BACKGROUND The authors compared the local anesthetic efficacy and safety of an intranasally administered formulation of tetracaine and oxymetazoline (K305) with placebo in adult participants undergoing single dental restorative procedures in teeth nos. 4 through 13. METHODS The authors screened and allocated 150 participants in a double-masked, randomized fashion to either K305 or placebo nasal spray. The authors delivered the study drug as two 0.2-milliliter sprays separated by 4 minutes inside the nostril on the side ipsilateral to the tooth being treated. The authors administered a third 0.2-mL spray, if necessary, and administered 4% articaine with 1:200,000 epinephrine by means of injection if anesthesia was inadequate. Safety evaluations included participant reports of adverse events, vital signs, and alcohol sniff tests during the 2-hour study period and at a 1-day follow-up visit. The primary efficacy end point was anesthetic success defined as the completion of the dental procedure without the need for rescue injectable local anesthetic. The authors evaluated differences in success rates observed between K305 and placebo by using a 1-sided Fisher exact test. RESULTS The overall success rates were 88.0% (95% confidence interval, 80.0-93.6) and 28% (95% confidence interval, 16.2-42.5) for K305 and placebo, respectively (P < .0001). The most frequent adverse effects in the K305 group were rhinorrhea (57.0%) and nasal congestion (26.0%). No serious adverse events occurred during this study. CONCLUSIONS K305 was effective and well tolerated during restorative procedures in adult participants. PRACTICAL IMPLICATIONS K305 provides a needleless alternative for obtaining maxillary pulpal anesthesia on premolars, canines, and incisors.

Managing a fractured implant: A clinical report

Implant fixture fracture is one of the reasons for late implant failure, with incidence rates ranging from 0.2% to 7.5%. Material defects, occlusal overload, prosthetic design, and nonpassive prosthesis fit have been identified as causative factors for implant fixture fractures. A custom-made prosthetic post was made to connect the remaining implant fixture and the implant-retained crown, as the fractured implant fixture exhibited no signs of infection and the fixture had adequate remaining length. In addition, complete removal of the implant could have resulted in significant bone loss at the site.