Aim. To evaluate the pain experience and behavior during dental injection, using the Wand computerized delivery system versus conventional local anesthesia in children and adolescents. Methods. An observational crossover split mouth study was performed on 67 patients (aged 7 to 15 years), requiring local anesthesia for dental treatments in both sides of the dental arch. Patients received both types of injections in two separate appointments, one with the use of a Computer Delivery System (the Wand STA system) and one with the traditional syringe. The following data were recorded: pain rating; changes in heart rate; level of collaboration; patient satisfaction. The data were analyzed using ANOVA for quantitative outcomes and nonparametric analysis (Kruskal–Wallis) for qualitative parameters. Results. The use of the Wand system determined significantly lower pain ratings and lower increase of heart rate than the traditional syringe. During injection, the number of patients showing a relaxed behavior was higher with the Wand than with the traditional local anesthesia. The patient level of satisfaction was higher with the Wand compared to the conventional local anesthesia. Conclusions. The Wand system may provide a less painful injection when compared to the conventional local anesthesia and it seemed to be better tolerated with respect to a traditional syringe.

This pilot study suggests that LLLT may be a valid technique to support the treatment of BRONJ-related pain, even though the low number of cases in this study does not permit any conclusive consideration.

extraction of third molars is the most common surgical procedure performed in oral surgery on a daily basis and, despite surgical skills and expertise, complications may occur. Complications observed during or after third molar removal may include pain, swelling, bleeding, infection, sinus perforation and nerve damage. Fortunately, with a proper management and a good surgical technique, the incidence of such events is low. Subcutaneous emphysema associated with dental extraction occurs when the air from the high-speed dental handpiece is forced into the soft tissue through the reflected flap and invades the adjacent tissues, leading to swelling, crepitus on palpation and occasionally spreading through the tissue spaces of the fascial planes. Although rare, iatrogenic subcutaneous emphysema can have serious and potentially life-threatening consequences. Care should be taken when using air-driven handpieces. The access of air into the facial tissues is not limited to tooth extractions, but may also occur through other portals of entrance, such as endodontically treated teeth, periodontium and lacerations of intraoral soft tissues. When subcutaneous emphysema occurs, it must be quickly diagnosed and properly managed to reduce the risk of further complications. This report presents a case of subcutaneous emphysema occurred during extraction of a mandibular third molar extraction with the use of an air turbine handpiece. Case management is described and issues relative to the diagnosis and prevention of this surgical complication are discussed.key Words: subcutaneous emphysema, third molar extraction, high pressure air instruments.

Objective: The purpose of this study was to compare secondary intention healing of oral soft tissues after laser surgery with and without the use of a compound containing amino acids and sodium hyaluronate. Background data: Sodium hyaluronate has been successfully used in medicine to promote healing. It has not been studied in the healing of laser-produced wounds. Materials and methods: Excisional biopsy was performed in oral soft tissues with a potassium-titanyl-phosphate (KTP) laser (532nm, SmartLite, DEKA, Florence, Italy) in 49 patients divided into two groups. In the study group (SG), 31 patients received a compound gel containing four amino acids and sodium hyaluronate (Aminogam((R)), Errekappa, Italy) after laser surgery; in the control group (CG), 18 subjects received no treatment involving a drug or gel. Numeric rating scale (NRS) was used to evaluate pain experienced after surgery [pain index (PI)]. Using a grid as a benchmark and computer software, the lesion area was measured after surgery (T-0) and after 7 days (T-1). A percentage healing index (PHI) was calculated indicating healing extension in 7 days. Results: SG cases showed an average PHI of 64.38 +/- 26.50, whereas the average PHI in the CG was 47.88%+/- 27.84. Mean PI was 2.67 +/- 0.96 for SG and 2.75 +/- 0.86 for CG. A statistically significant difference was detected between the groups for PHI (p=0.0447), whereas no difference was detectable for PI (p=0.77). Conclusions: The use of a gel containing amino acids and sodium hyaluronate can promote faster healing via secondary intention in laser-induced wounds, although it does not seem to affect pain perception