The patients who received Plain Lignocaine perceived less pain during injection of local anaesthetic solution when compared to patients who received lignocaine with vasoconstrictor. The early post-operative wound healing was better in patients anaesthetized by Plain Lignocaine.
Objective:The aim of this randomized clinical trial was to assess the efficacy of exclusive lingual nerve block (LNB) in achieving selective lingual soft-tissue anesthesia in comparison with conventional inferior alveolar nerve block (IANB).Materials and Methods:A total of 200 patients indicated for the extraction of lower premolars were recruited for the study. The samples were allocated by randomization into control and study groups. Lingual soft-tissue anesthesia was achieved by IANB and exclusive LNB in the control and study group, respectively. The primary outcome variable studied was anesthesia of ipsilateral lingual mucoperiosteum, floor of mouth and tongue. The secondary variables assessed were (1) taste sensation immediately following administration of local anesthesia and (2) mouth opening and lingual nerve paresthesia on the first postoperative day.Results:Data analysis for descriptive and inferential statistics was performed using SPSS (IBM SPSS Statistics for Windows, Version 22.0, Armonk, NY: IBM Corp. Released 2013) and a P < 0.05 was considered statistically significant. In comparison with the control group, the study group (LNB) showed statistically significant anesthesia of the lingual gingiva of incisors, molars, anterior floor of the mouth, and anterior tongue.Conclusion:Exclusive LNB is superior to IAN nerve block in achieving selective anesthesia of lingual soft tissues. It is technically simple and associated with minimal complications as compared to IAN block.
PurposeThe fractures of anterior mandible are subject to severe torsional forces due to muscles acting in opposite directions. 3D miniplate has been suggested as a good alternative by some researchers. However, finite element model (FEM) studies indicate that labio-inferior positioning of two miniplates perpendicular to each other offers better stability as compared to labial positioning. This study aims at combining the advantages of a single 3D miniplate and labio-inferior positioning of two conventional miniplates, which was assessed by finite element analysis along with a pilot clinical trial.MethodsTwo FEM models were created using CT data of a 24-year-old patient with Angle class I occlusion: control model with labial plating and study model with labio-inferior plating. The models were processed with MIMICS® (materialise, Leuven, Belgium), CATIA® (Dassault Systemes) and finite element analysis softwares. Parameters adopted for analysis were (1) displacement (mm) of fracture fragments during each screw fixation, (2) lingual splay and post fixation stability of fracture fragments with masticatory load, and (3) stress distribution (MPa) across fracture fragments. Moreover, a pilot clinical trial including five patients with anterior mandible fracture was conducted. The fractures were managed by intraoral open reduction and 3D miniplate fixation in labio-inferior position. Intraoperative interfragmentary gap, post fixation lingual splay and radiographic fracture union and complications were assessed clinically.ResultsLabio-inferior plating demonstrated less displacement (mm) of fracture fragments during screw fixation (0.059 vs. 0.079) as well as after application of masticatory load (1.805 vs. 1.860). Negligible lingual splay and less stress distribution (MPa) across fracture fragments (1.860 vs. 1.847) were appreciated in the study group as compared to control group. Clinical trial support the favorable outcome related to intraoperative and postoperative assessment parameters.ConclusionFEM analysis and clinical trial reveal better results with labio-inferior positioning of 3D miniplate when compared to labial positioning.
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