The location of the mandibular foramen (MF) on digital panoramic radiographs can be an important guide for clinicians when administering the inferior alveolar nerve block (IANB) for dental anesthesia of the mandible. This study, aimed to assess the location of the MF relative to the anterior border (AB) of the ramus and the occlusal plane (OP) from digital panoramic radiographs. An observational case series study was conducted on digital panoramic radiographs from the oral and maxillofacial radiology department archives of patients at least 18 years of age with a 1:1 scale (100%). The samples had to have at least 2 lower molar teeth on both sides without any blurring, previous fracture of the ramus or other artifacts. The distance of the MF to the OP and the AB of the ramus was measured using a caliper. The role of age and gender were also analyzed statistically using the 2-way analysis of variance test. One hundred ninety-four digital panoramic radiographs were included in the analysis. The findings showed that the vertical distance of the MF to the OP was a maximum of 14.52 mm and a minimum of −3.0 mm (mean 4.32 ± 2.34 mm). The distance of the MF to the AB of the ramus was a maximum of 25.52 and a minimum 9.68 mm (mean 16.48 ± 3.28 mm). Based on these findings, the IANB target site for injection should be approximately 5 mm above the OP and approximately 16.5 mm beyond the AB of the ramus to achieve successful anesthesia of the mandible via standard IANB in an Iranian population.

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BackgroundThis prospective, randomized, double-blind, clinical study was conducted to compare the effects of 4% articaine with 1:100,000 epinephrine (A100) and 4% articaine with 1:200,000 epinephrine (A200) on the vital signs and onset and duration of anesthesia in an inferior alveolar nerve block (IANB).MethodsIn the first appointment, an IANB was performed by injecting A100 or A200 in 1 side of the mouth (right or left) randomly in patients referred for extraction of both their first mandibular molars. In the second appointment, the protocol was repeated and the other anesthetic solution was injected in the side that had not received the block in the previous session. Systolic and diastolic blood pressures (SBP and DBP) and pulse rate were measured during and 5 min after the injection. The onset and duration of anesthesia were also evaluated. Data were analyzed using t-test and Mann-Whitney U-test, and p-value was set at 0.05.ResultsSBP and pulse rate changes were slightly more with A100; however, DBP changes were more with A200, although the differences were not significant (P > 0.05). There were no statistically significant differences in the parameters evaluated in this study. The onset and duration of anesthesia, and the changes in SBP, DBP, and pulse rate during and 5 min after the injection were the same in both the groups.ConclusionsFor an IANB, A200 and A100 were equally efficient and successful in producing the block. Epinephrine concentration did not influence the effects of 4% articaine.

Oral and maxillofacial surgeons play a major role in therapy, preventing morbidity, mortality from odontogenic and non-odontogenic maxillofacial infections therefore, it is essential to have knowledge of current advancements in microbiological diagnosis and antibiotic therapy for odontogenic maxillofacial infections. Fortunately, we live in an era where antibiotics are readily available to prevent and treat against infections. The exact cause should be determined once the specific antibiotic is prescribed additionally, the empirical, definitive treatments, side effects, pharmacokinetics and pharmacodynamics of antibacterial agents have to be considered.Nowadays, antimicrobial resistance which is spreading rapidly is of great concern, because it is common in hospitals where acquired infections can be perilous. This situation compels scientists to synthesize new antibiotics and treatment modalities. The reason of microbial resistance can be due to increased misuse of antibiotics in foods livestock, poultry and agriculture . " number of significant factors, such as organism identification, antibiotic sensitivity testing and host factor situations, should be taken into account in order to treat various infections effectively.Currently, investigations are ongoing to impede antibacterial resistance by nanoscience technology seeking new chemotherapeutic agents. Scientists focusing on microbiological investigations aim to invent novel nanoantibiotic agents with high efficiency, low toxicity and low percentage of resistance. In recent years, nanoantibiotics have been applied against infections intelligently. The average size, polydispersity and composition of generated nanomaterials can be controlled by various methods in order to make them appropriate for biomedical applications.

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The mean age of the patients in our study was 39.54 ± 15 years. Thirty-five patients were male, and 25 were female. The serum blood glucose level was 111.6 ± 25.47 mg/dL before local anesthesia and 115.3 ± 24.39 mg/dL after tooth extraction (P = 0.418). Eleven female patients and four male patients had a reduction in the blood glucose levels after injection. There was a significant difference between these groups (P = 0.01). Conclusion: According to our findings and previous reports, using local anesthesia during tooth extraction does not induce hypoglycemia and could increase the serum blood glucose level in individuals.

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Purpose: The inferior alveolar nerve block (IANB) is a necessary and frequent local anesthetic injection in dental practice in which the conventional technique is generally applied. However, multiple studies reported that the failure rate of IANB is high, whereupon our study aimed to assess the modified and conventional IANB techniques, concerning the success rate. Methods: A split-mouth single-blind randomized clinical trial study was conducted on 42 patients (84 cases) as paired analyzing, between 18 to 55 years-old, who needed bilateral IANB for posterior mandibular teeth extraction. To apply the modified technique, the barrel of the syringe was located in the corner of the mouth; while mouth is open wide and the needle-penetrated mucosa exactly lateral (anterior) to the pterygomandibular fold (PMF). The needlepoint was 5–15 mm above the occlusal plane (OP) according to the digital panoramic radiography and parallel to OP. The outcomes were analyzed using the Cochran-Mantel-Haenszel test. Results: The success rates were 97.6% in the modified IANB and 83.3% in the conventional technique, evaluating in the first 10 minutes.Conclusion: The clinician can operate IANB by modified technique with fewer anatomical landmarks, clear injection points and the higher success rate upon which the performance will be easy by the beginners. Trial registration IRCT20150924024167N2, on 07.03.2020, was retrospectively registered.