Local pain management is the most critical aspect of patient care in dentistry. When efforts to achieve local anesthesia are unsuccessful, the resulting stress for both the patient and practitioner can be significant. It is imperative on our part to update our knowledge and skills in using newer alternatives in pain control and management and ways of administering them to increase the comfort level of our patients and resolve the clichéd paradigm of "Pain and Dentistry are inseparable". The improvements in techniques for local anesthesia are probably the most significant advances that have occurred in dental science. This paper provides an update on comparatively newer gadgets that are less commonly used to deliver local anesthetics.
<p class="abstract"><strong>Background:</strong> <span lang="EN-IN">The aim of this study was to evaluate efficacy of segmental cone beam computed tomography (CBCT) in detecting bony changes in condyle and thickness of roof of glenoid fossa in temporomandibular joint (TMJ) disorders.</span></p><p class="abstract"><strong>Methods:</strong> The study group comprised of 10 temporomandibular disorders (TMD) patients of either sex between the age group of 20-60 years diagnosed as TMDs by clinical evaluation using the research diagnostic criteria was considered. After the clinical examination, radiographic investigations were carried out which included digital OPG, transcranial radiograph and CBCT scan. TMJ Evaluation included: (a) bony changes of the condyle (flattening, erosion, sclerosis, osteophytes, resorption); (b) joint space (normal, increased, reduced, bony contact between the condyle and the mandibular fossa); and (c) bony changes of mandibular fossa (normal, sclerosis, erosion, resorption). The radiographic findings were statistically analysed.<strong></strong></p><p class="abstract"><strong>Results:</strong> <span lang="EN-IN">Significant difference between OPG, transcranial and CBCT were found for the presence of erosion (P =0.000), thickness of roof of glenoid fossa (P =0.000), deformed contour (P =0.001), joint space (P =0.011), subchondral sclerosis (P =0.011), irregularity of articular surface and eminence (P =0.000), flattening (P =0.050). </span></p><p class="abstract"><strong>Conclusions:</strong> Using CBCT as imaging technique in our study to detect osseous changes in the TMJ was proved to be effective as compared to the conventional radiographic techniques, the results achieved with CBCT was 100%.The results obtained in our study prove to be a full proof one and it seems to promise to go one step closer to detect progression and severity of the osseous changes in the condylar head and mandibular fossa in patients with TMDs<span lang="EN-IN">.</span></p>
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