Objectives: To evaluate hemodynamic changes of blood pressure and heart rate on hypertensive patients undergoing tooth extraction using various types of local anesthesia (LA). Study Design: A prospective randomized clinical trial was conducted on 45 hypertensive patients who were divided equally into 3 parallel groups according to LA received. Group 1: Lidociane 2% with epinephrine 1: 80,000. Group 2: Prilocaine 3% with Felypressin 0.03 IU/ml. Group 3: Mepivacaine 3% plain. Inclusion criteria: hypertensive patients, under medical management with blood pressure ≤ 159/99. Exclusion criteria: Blood pressure ≥160 /100 and patients receiving β blockers. Negative aspiration was mandatory before the injection of 2 cartridges of LA. Blood pressure and heart rate were evaluated by Electronic Sphygmomanometer and Pulse Oximeters in 3 different time-points; 3 minutes before LA, three minutes after LA and three minutes after extraction. Results: The mean of systolic blood pressure (SBP) had increased after LA injection, and then decreased after extraction in the 3 groups of patients. Increase of SBP after extraction with (Mepivacaine plain) was higher than (Lidociane with Epinephrine) and the difference was statistically significant using ANOVA (p=0.037). The differences in the mean heart rates and mean diastolic blood pressures in the 3 groups were not significant. Conclusions: The increase of blood pressure with Epinephrine and Felypressin is negligible. Therefore, it is safe to use 2 cartridges of Lidociane 2% with Epinephrine 1:80,000 or Prilocaine 3% with Felypressin 0.03 IU/ml for hypertensive patients whose blood pressure ≤ 159/99 provided negative aspiration is verified before injection. Key words:Local anesthesia, tooth extraction, hypertensive patients, vasoconstrictors, epinephrine, Felypressin.

Spindle cell lipoma (SCL) is a benign lipomatous neoplasm typically located in the posterior neck and back of older males. It presents as a well-circumscribed mass in the buccal mucosa, tongue, floor of the mouth or hard palate. There are only two case reports of SCL in the gingiva and alveolar ridge. Here, we report a case of SCL in the mandibular mucogingival junction of a 68-year-old male. Clinical, histopathological and immunohistochemical findings are presented. Although oral SCL is rare, it should be considered in the differential diagnosis of spindle cell neoplasms occurring in the oral cavity.

Introduction:The greater palatine foramen (GPF) and incisive canal foramen (ICF) play an important role in administering the local anesthetics.Aim: To evaluate the anatomic and morphologic variability of GPF and ICF in relation to age and gender of Saudi dental patients using cone beam computed tomography (CBCT) scans. Materials and methods:This descriptive cross-sectional study evaluated the 182 CBCT scans of Saudi dental patients who were examined for GPF (n = 364) and ICF (n = 182) who had attended a private dental school. The relationship of GPF and ICF to the surrounding structures, midline maxillary suture (MMS) to the posterior border of the maxilla, dimensions and opening direction of ICF, and the dimensions of the canals were evaluated. Chi-square test, independent Student's t-test, and analysis of variance (ANOVA) tests were applied to elicit statistical significance.Results: Findings revealed that the gender variations were significant in lateral to medial diameter GPF, GPF distance to midline, GPF distance to posterior maxilla, and distance between ICF to GPF. Similarly, age groups showed differences in GPF distance to midline, and distance between ICF and GPF. A significant positive correlation between age and distance of IC to GPF was observed (r = 0.14, p = 0.007). Age showed a significant positive correlation with IC length (r = 0.151, p = 0.041). Conclusion:Age and gender differences were obvious with regard to dimension and morphology of the GPF, ICF, and other adjacent structures among Saudi dental patients as revealed by CBCT scans.

Objective. Our study aimed to determine the prevalence, location, and morphological differences of the septa using CBCT images. Methods. This retrospective study was conducted on CBCT examinations. The sample included both mixed and permanent dentition and edentulous patients. The images were viewed in 3 planes (sagittal, coronal, and axial) and the left and right maxillary sinuses were evaluated for the septa’s prevalence, location, and morphological differences. Results. The measurements were statistically analyzed using SPSS software. Out of 200, 122 patients showed one or more bony septa in the maxillary sinus. The septal location and angulation were not limited to a specific area or a specific range. Significant differences between genders were found. Conclusions. The increased surface area of the septa using plane 2-dimensional radiographs is impossible. CBCT has improved the planning of any sinus procedure and offers adequate information compared to conventional radiographs.

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