Differentiation of true from mimicking Eagle’s syndrome based on conventional radiography is difficult; however, cone beam computed tomography (CBCT) images can contribute to proper diagnosis of mimicking Eagle’s syndrome. The aim was to study radiological images of a 37-year old female patient (patient #1), with chronic cervicofacial pain who underwent radiological diagnosis with a conventional panoramic machine; another 75-year old male patient (patient #2), with chronic oropharyngeal pain, underwent a radiological diagnosis with the CBCT machine, with a field of a view of 16 × 12 cm. Exposure factors were 120 kVp, 7 mA, with a 20 s exposure time of acquisition. The results show a panoramic image (patient #1) with a pathologically elongated styloid process 46 mm of length, which was surgically removed, releasing the patient from further pain episodes. CBCT acquisition (patient #2) showed an impacted left maxillary canine in the edentulous maxilla and a peculiar elongation of both stylohyoid complexes as impressive, “collar-like”, bilateral, elongated, multiple segmented, calcified stylohyoid complexes, without pressure on the vital neurovascular neck structures, mimicking true Eagle’s syndrome. The impacted maxillary canine was surgically extracted with a subsequent resolution of pain episodes and the cessation of neurological complaints. The conclusions suggest that the use of CBCT images can contribute to differentiating mimicking from true Eagle’s syndrome, which has been rarely reported in the literature.

Background: Perineurally adding dexamethasone to local anesthetics could enable postoperative analgesia. Our aim was to investigate the efficacy of 4 mg dexamethasone and 0.5% ropivacaine on the prolonged duration of mandibular anesthesia for postoperative analgesia during third molar surgery. Materials and method: The patients of both sexes, and in the age range of 17 to 50 yrs of age, received the Gow-Gates anesthesia. Group I received 4 mL of plain 0.5% ropivacaine, with perineurally added 1 mL/4 mg of dexamethasone; group II received 4 mL of plain 0.5% ropivacaine with perineurally added 1 mL of 0.9% saline; group III received 4 mL of plain 0.5 bupivacaine with perineurally added 1 mL of 0.9% saline. The prime anesthesia outcome was the duration of conduction anesthesia (DCA); the secondary outcome was the duration of analgesia (DAN) and analgesia before analgesic intake. Results: In 45 randomly selected subjects (mean age 27.06 ± 8.20), DCA was statistically longest in group I (n = 15) (592.50 ± 161.75 min, p = 0.001), collated with groups II (n = 15) and III (n = 15) (307.40 ± 84.71 and 367.07 ± 170.52 min, respectively). DAN was significantly the longest in group I (mean: 654.9 ± 198.4 min, p = 0.001), compared with group II (345.4 ± 88.0 min) and group III (413.7 ± 152.3 min), with insignificant adverse reactions. One-third of the operated patients absented from the use of analgesics. Conclusion: A amount 0.5% ropivacaine with dexamethasone usefully served as an analgesic with a success rate of 93.4% of the given anesthesia.

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Uvod:Lokalni anestetici su najčešće korišćeni lekovi u svakodnevnoj stomatološkoj i medicinskoj, a sve češće i u kozmetičkoj praksi. Danas postoji veliki broj lokalnih anestetika koji su prema strukturi podeljeni na dve grupe: estarske i amidne lokalne anestetike. Iako je njihova primena u svakodnevnom radu uglavnom bezbedna, nije isključena mogućnost pojave negativnih reakcija koje mogu biti psihogene, toksične, imunološke i specifične neželjene reakcije. Cilj: ovog rada je da ukaže na mehanizam nastanka i simptomatologiju mogućih negativnih reakcija na lokalne anestetike. Zaključak:Ukoliko dođe do pojave sistemske neželjene reakcije na lokalni anestetik, najveći problem, u kliničkoj praksi, predstavlja prepoznavanje prirode negativne reakcije i pružanje adekvatne terapije u vezi sa nastalom reakcijom.Brzina i sigurnost u prepoznavanju neželjene reakcije na lokalni anestetik, nekada mogu biti od životnog značaja za bolesnika. AbstractIntroduction: Local anesthetics are the most commonly used drugs in everyday dental and medical and increasingly in cosmetic practice. Today there are a number of local anesthetics that are divided into two groups based on their structure: ester and amide local anesthetics. Although their use in everyday work is generally safe, there is a possibility of adverse reactions that may be psychogenic, toxic, immunologic and specific adverse reactions. The aim of this work is to highlight the mechanism of occurrence and symptoms of possible adverse reactions to local anesthetics. Conclusion: If you experience systemic adverse reactions to the local anesthetic, the biggest problem in clinical practice, is a recognition of the nature of adverse reactions and providing appropriate therapy in conjunction with the resulting reaction. Speed and security to identify adverse reactions to local anesthetic can be of vital importance for the patient.

Introduction: The role of aesthetic dentistry in the field of fixed dental prosthetics is to redesign the smile, which means not only the treatment on the teeth, but also the treatment of the surrounding soft tissues. Successful therapy can be achieved by establishing the harmony between the static (teeth, gingiva) and dynamic factors (lips, cheeks, mimic muscles) at rest and when performing various functions of the orofacial system. The aim: of the study was to analyze the parameters of the oral soft tissues (gingival health, gingival height, gingival zeniths, lip line and symmetry and balance of the dentition) that affect the aesthetics of fixed prosthodontic restorations. Literature data and clinical experience were used. Conclusion: Adherence to the described parameters is of great importance in the development of aesthetic and functional fixed prosthetic restoration.