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Biomedical subjects

J G Meechan

Publications and source records attributed to J G Meechan.

At least 19 recordsLinked to original sources
PubMed2000

Intra-oral topical anaesthetics: a review.

OBJECTIVE: This review considers the use of topical anaesthetics in the mouth to reduce the discomfort of local anaesthetic injections and intra-oral operative procedures. DATA SOURCES: Electronic literature search using Pub Med, manual search of references within papers found by the primary search and manual searching of abstracts from scientific meetings. STUDY SELECTION: The articles selected for this review investigate or used topical anaesthesia in dental procedures. CONCLUSIONS: The use of topical anaesthetics does not guarantee pain-free dental local anaesthesia. Efficacy is dependent upon the duration of application and the gauge of needle used. Evidence is available that the use of topical anaesthesia alone is sufficient to perform some intra-oral procedures including periodontal manipulations, operative dentistry and oral surgery.

Administration, Topical↗
PubMed2000

The efficacy of Emla and 5% lignocaine gel for anaesthesia of human gingival mucosa.

OBJECTIVE: To compare the analgesic effect of a mixture of 2.5% lignocaine and 2.5% prilocaine (Emla) with that of lignocaine gel alone for minor operations on the gingiva. DESIGN: Randomized double-blind trial. SETTING: Teaching hospital, UK. SUBJECTS: 10 healthy dental students (7 men and 3 women, 20-21 years old). INTERVENTIONS: Construction of a reservoir within a splint on each side of the mouth and insertion of splints. The volunteers acted as their own controls, and the sides used for each anaesthetic were chosen at random. MAIN OUTCOME MEASURES: Measurement of pressure-pain threshold by a standard technique. RESULTS: The median (range) duration of anaesthesia after Emla (22.5, 12-30) was significantly longer than after lignocaine alone (12.5, 0-25) (P=0.01), and the area under the curve for the pressure-pain threshold for Emla (2053, 199-4564) was significantly greater than for lignocaine alone (986, 169-2942) (P=0.01). CONCLUSION: Emla is a more effective topical anaesthetic agent than lignocaine alone. Although its duration of action is relatively short it is adequate for minor operations on the gingiva.

Adult↗
PubMed1999

How to overcome failed local anaesthesia.

Local anaesthetic failure is an unavoidable aspect of dental practice. A number of factors contribute to this, which may be related to either the patient or the operator. Patient-dependent factors may be anatomical, pathological or psychological. This paper considers the reasons for unsuccessful dental local anaesthetic injections and describes techniques which may be useful in overcoming failure.

Anesthesia, Dental↗
PubMed1999

A comparison of 2 topical anesthetics on the discomfort of intraligamentary injections: a double-blind, split-mouth volunteer clinical trial.

OBJECTIVE: The purpose of this volunteer clinical trial was to compare the effects of 5% lidocaine ointment and EMLA cream on the discomfort associated with intraligamentary injections. STUDY DESIGN: A double-blind, split mouth study was conducted. Each of 10 healthy volunteers had 5% lidocaine and EMLA cream applied to the maxillary premolar buccal gingiva for 5 minutes before the administration of an intraligamentary injection. Discomfort during the injection was assessed through use of a visual analog scale. Data were analyzed by means of Student paired and unpaired t tests. RESULTS: Injection discomfort on the side on which EMLA cream was applied was significantly less than on the lidocaine side (t = 2.32, P < .05). CONCLUSIONS: EMLA cream reduced the discomfort associated with intraligamentary injections.

Adult↗
PubMed1999

Autotransplantation as a treatment option after loss of a maxillary permanent incisor tooth. A case report.

A case is described of the management of a maxillary left permanent incisor, damaged by several traumatic injuries, in a 13-year-old girl. The traumatized incisor tooth required extraction and as part of an orthodontic treatment plan, a mandibular left second premolar was surgically transplanted to the prepared extraction socket at the maxillary anterior alveolus. After splinting, the transplanted tooth underwent endodontic treatment, because of pulpal necrosis. Orthodontic treatment commenced 3 months post-transplantation. Permanent root obturation was provided after orthodontic treatment and a porcelain veneer was placed to restore aesthetic appearance. The case emphasizes the importance of correct case selection, a multidisciplinary approach to treatment planning, and regular follow-up for transplanted teeth.

Adolescent↗
PubMed1999

Drug abuse and dentistry.

This paper describes the influence of the misuse of drugs on dental treatment and the effects of drugs of abuse on the orodental structures.

Humans↗
PubMed1997

Plasma potassium changes in hypertensive patients undergoing oral surgery with local anesthetics containing epinephrine.

Blood pressure, heart rate, and plasma potassium concentration were measured before and 10 min following the injection of 4.4 ml of 2% lidocaine with 1:80,000 epinephrine in 14 patients receiving treatment for hypertension. Patients were divided into two groups. Group 1 was receiving treatment with non-potassium-sparing diuretics and group 2 was being treated with nonselective beta-adrenergic antagonists. No significant changes in systolic or diastolic blood pressures were detected between groups at 10 min. The change in heart rates from the preinjection value differed between groups at 10 min (P < 0.02). Ten minutes following the injection of the local anesthetic, plasma potassium concentration was significantly reduced in group 1 patients compared to both baseline and the change in group 2 patients (P < 0.05).

Anesthesia, Dental↗
PubMed1997

Adverse effects of dental local anaesthesia.

This paper considers the adverse effects that a patient may suffer as a result of anticipating an injection of dental local anaesthetic. Although most of these are extremely rare (a testimony to good technique), the dental practitioner should be aware of the possibility of their occurrence and of ways to deal with them.

Anesthesia, Dental↗
PubMed1996

A comparison of topical anaesthesia and electronic nerve stimulation for reducing the pain of intra-oral injections.

This paper describes a model for investigating the efficacy of different methods of alleviating the pain of intra-oral injections. The efficacies of the topical anaesthetic EMLA cream and electronic nerve stimulation as means of reducing the discomfort of palatal injections prior to the extraction of maxillary teeth were investigated using the model in one hundred patients. EMLA reduced the pain of injection compared with placebo (P < 0.05) whereas the pain reported after electronic nerve stimulation did not differ significantly from placebo. It is concluded that EMLA is useful in reducing the pain of palatal injections.

Administration, Buccal↗
PubMed1996

Bonding of composite to bone: durability and effect of drying time.

This paper describes a further step in the evaluation of dentine-bonding agents as a means of securing fixation devices to bone. This screening study investigated the durability and effect of bone drying time on the bond strength obtained between composite and bone using the dentine-bonding agent All-bond 2. The strength of bond obtained after air-drying bone for 1 sec did not alter significantly over a 6-week period. However, the bond strength became significantly poorer over the 6-week period in bone which had been air-dried for 1 min.

Analysis of Variance↗
PubMed1996

The use of inhalation sedation and local anaesthesia instead of general anaesthesia for extractions and minor oral surgery in children: a prospective study.

One hundred and thirty-three children aged 4-17 years were treated to assess the viability of operating a regular inhalation sedation service for extractions and minor oral surgery in children. The study evaluated treatment success, assessed parents' and children's satisfaction, and compared the cost of inhalation sedation with that of existing general anaesthesia services. Eighty-four per cent of the children had been referred for orthodontic extractions. Treatment was successfully completed for 120 of the patients; 201 permanent and 130 primary teeth were extracted and six minor surgical procedures were performed. Postal questionnaire assessment of the parents' and children's views showed that 97% were satisfied with the treatment provided. Of those parents who had previous experience of general anaesthesia, 79% stated that inhalation sedation was 'better' or 'much better' than general anaesthesia. It was estimated that the cost of providing treatment under inhalation sedation was considerable less than under general anaesthesia. It was concluded that it is viable to offer a regular inhalation sedation service for orthodontic extractions in children because it is clinically successful, acceptable to children and their parents, and cost-effective.

Administration, Inhalation↗
PubMed1995

The hazards of chronic exposure to nitrous oxide: an update.

This paper reviews the potential occupational hazards associated with chronic exposure to nitrous oxide. The evidence that chronic exposure to the gas produces problems related to reproduction in dental personnel is convincing. Recent evidence suggests that scavenging systems decrease the adverse effects which nitrous oxide has on fertility of dental surgery assistants. However, even in the presence of scavenging systems trace levels of the gas can exceed recommended minimum levels.

Air Pollution, Indoor↗
PubMed1995

A comparison of the bond strengths of two different dentine-bonding agents to bone.

PURPOSE: This study was performed to test the bond strength obtained between composite and bone using two different dentine-bonding agents. MATERIALS AND METHODS: P50 composite was bonded to 60 specimens of pig calvarium using All bond 2 (Bisco, Itaska, IL) or A.R.T. bond (Coltene, Altstatten, Switzerland) dentine-bonding agents. The bonds were tested to failure in an Instron Universal Testing machine (High Wycombe, UK) and the bond strength calculated. Data were analysed using the Weibull distribution. RESULTS: All-bond 2 and A.R.T. bond produced mean bond strengths of 8.5 MPa and 8.4 MPa, respectively, in the model used. The Weibull moduli were 2.4 and 2.1, respectively. CONCLUSIONS: There was no significant difference in the performance of the adhesives tested when used to bond composite to bone. The bond strengths obtained give rise to some optimism over the possible use of these systems in bone fracture fixation.

Animals↗
PubMed1995

Relationship between fractures of the mandibular angle and the presence and state of eruption of the lower third molar.

OBJECTIVES: This study attempted to relate the incidence of fractures at the mandibular angle with the presence and state of eruption of lower third molars. STUDY DESIGN: The records and radiographs of 200 patients with mandibular fractures were examined. The presence and degree of impaction of lower third molars were assessed for each patient and related to the occurrence of fractures of the mandibular angle. Data were analyzed by chi-square statistic and the Student's t test. RESULTS: The incidence of angle fractures was found to be significantly greater when unerupted lower third molars were present (p < 0.001). Bilateral unerupted third molar teeth predisposed to a fracture at the angle significantly more than unilateral unerupted third molars (p < 0.01). Furthermore, the amount of bony space occupied by an unerupted third molar tooth directly related to the weakness of that area of bone (p < 0.001). CONCLUSIONS: This study provides clinical evidence to suggest that unerupted third molar teeth weaken the mandibular angle both quantitatively and qualitatively.

Adolescent↗
PubMed1995

The effect of storage temperature on the resistance to failure of dental local anesthetic cartridges.

This in vitro investigation studied the effect of storing dental local anesthetic cartridges at room temperature and at 37 degrees C on the forces required for cartridge failure under strong injection pressures. Storage for three hours at the higher temperature resulted in a significant reduction in the forces required to produce failure of plastic cartridges (leakage of solution around the bung). The forces needed to cause failure of glass cartridges did not differ between the two temperatures.

Anesthesia, Dental↗