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Objective: The purpose of this study was to compare the clinical efficacy of articaine at 4% (epinephrine 1:100,000) with bupivacaine at 0.5% (epinephrine 1:200,000) for surgical extraction of impacted mandibular third molars. Study Design: This was a randomized, double blind, split-mouth, clinical trial. Thirty-six patients took part and underwent extraction of 72 lower third molars. The variables studied were: anesthetic latency time, intra-operative bleeding, anesthetic quality, hemodynamic changes during the surgical intervention, anesthetic duration in the soft tissues, post-operative analgesia and post-operative pain at 2, 6, 12 and 24 hours using a visual analogue scale, as well as any need for additional rescue medication. Results: Latency time was 2.0 minutes for articaine and 3.1 minutes for bupivacaine, with statistically significant difference (p<0.05). Bleeding was greater when bupivacaine was used (p<0.05) and anesthetic quality was greater with articaine (p<0.05). The duration of soft tissue anesthesia was longer with bupivacaine (p<0.05). Differences in post-operative analgesia, haemodynamic changes, post-operative pain and the quantity of rescue medication consumed were not statistically significant (p>0.05). Conclusions: Articaine showed greater clinical efficacy than bupivacaine, reducing latency time, bleeding, anesthetic duration in the soft tissues and achieving higher anesthetic quality, requiring less reinforcement during surgery than bupivacaine. Key words:Articaine, bupivacaine, anesthetic efficacy, impacted mandibular third molar.

Background Proliferative verrucous leukoplakia, recently coined as proliferative leukoplakia (PL), is associated with a strong tendency to recur after treatment and an elevated rate of malignant transformation. We compared the clinical characteristics of patients with gingival PL with and without progression to oral squamous cell carcinoma. Methods The patients were divided into two groups: group 1 included 33 patients with gingival PL that did not progress to cancer, and group 2 included 30 patients with PL who developed malignant transformation during follow‐up. We compared age, sex, tobacco habit, clinical characteristics of gingival PL lesions, and location, tumor‐node‐metastasis (TNM) stage, and clinical characteristics of gingival malignancy between groups. Results Female sex was predominant in the group with gingival cancer, and simultaneous involvement of the buccal mucosa, tongue, and palate was more common in this group than in the group without cancer. PL lesions were also largest in the group of patients with cancer. Most gingival cancer occurred in areas with teeth and took the form of oral ulceration. TNM stage I was most common. Conclusions The simultaneous presence of lesions on the buccal mucosa, grade of lesion extension, and presence of ulcerative lesion were significantly associated with gingival cancer in patients with PL.

Resumen: Las enfermedades vesículo-ampollares de la mucosa oral pueden estar producidas por agentes mecánicos, físicos o químicos, por microorganismos, o por desórdenes inmunológicos o alérgicos. Dentro de los procesos ampollares de base inmunológica se encuentran el eritema exudativo multiforme, el pénfigo vulgar, el penfigoide, el liquen plano, el lupus eritematoso, la dermatitis herpetiforme y la enfermedad por depósito lineal de IgA. Este artí-culo presenta una revisión de los diferentes aspectos etiopatogénicos, clínicos, y terapéuticos de los penfigoides dentro de las enfermedades ampollares de la cavidad oral. Además se realiza una puesta al día, exponiendo los criterios diagnósticos, así como las técnicas más importantes empleadas en el mismo. A review is provided of the different etiopathogenic, clinical and therapeutic aspects of pemphigoid disorders among the range of ampullar diseases of the oral cavity. An update is also provided, with a description of the diagnostic criteria and principal techniques employed. Milián-Masanet MA, Sanchis-Bielsa JM. Penfigoides: revisión y puerta al día.