Aims: To assess the effect of alkalization of local anesthetic solution for the purpose of enhancing its efficiency in periapical surgery. Materials and Methods: A total sample of 80 patients, all needing periapical surgery on one or more of their upper anterior tooth (teeth) was subjected to this trial. For the purpose of comparison, the sample was randomly divided into two groups based on the local anesthetic solution that they were to receive before surgery. The first group(control) included those patients who received the commercially available local anesthetic solution with a standard pH of 3.5.The second group (trial group) included those patients who received a pH adjusted local anesthetic solution at 7.2 (using sodium bicarbonate).Prior to, and at the completion of intended surgery, the following data were recorded: Pain during injection, onset of achievement of surgical anesthesia, pain during operation and the duration of operation itself. Results: A significant difference in regard to onset of achievement of surgical anesthesia between both groups was noticed with a faster onset in group two where the patients received a pH adjusted local anesthetic solution when compared to control group where the patients received the commercially available local anesthetic solution. Also, less pain on deposition of solution was noticed in the second group as well as less pain score levels were recorded during operation in regard to the same group. Conclusion: The pH adjusted local anesthetic solutions may provide certain advantages when compared to the commercially available local anesthetic solutions regarding enhancement of anesthetic efficiency, reduced pain on injection as well as during surgery.

Aims: To compare three maxillary nerve block techniques of local anesthesia in terms of success during minor oral surgical procedures on maxillary teeth. Materials and Methods: The clinical trial was conducted at the

Aims:A clinical trial was carried out to assess the efficiency of a single buccal injection to achieve anesthesia of the buccal aspect of the upper first molar instead of the traditional two injections. Materials and Methods: The subjects included in the clinical assessment were those needing extraction of an upper first molar of either side. For the purpose of comparison, the sample was randomly divided into two main groups: Group I (control group) which included 100 subjects who were to receive two buccal injections and a single palatal injection before extraction. While Group II (trial group) included 100 subjects who were to receive a single buccal injection and a single palatal injection before extraction. The following data were recorded: Pain on needle insertion, pain on deposition of solution, onset of surgical anesthesia and adequate surgical anesthesia. Results: The first criterion recorded was pain on needle insertion where the results showed no significant difference between both groups. The second criterion was pain on deposition of solution. Here the results also showed no significant difference between both groups in this aspect. For onset of surgical anesthesia, no significant difference was shown between both groups. In regard to pain grade experienced during surgery for both groups, the results showed that grade A anesthesia was recorded in 95% of patients in group I , whereas in 93% of patients in group II. Grade B anesthesia was recorded in 5% of patients in group I and in 7% of patients in group II. Statistically speaking, no significant difference was disclosed in regard to pain assessed during the extraction of the tooth between both groups. Conclusions: The achievement of successful local anesthesia is a continual challenge in dentistry. Any suggested new approach for achieving adequate anesthesia for either the maxilla or mandible as long as it is safe and effective can be recommended for routine dental care.

Aims:To evaluate the effect of local irrigation with tranexamic acid in minimizing post-operative bleeding following the removal of impacted lower wisdom teeth. Materials and Methods: This clinical trial was conducted at the Department of Oral and Maxillofacial Surgery / College of Dentistry / University of Mosul. The sample recruited comprised twenty healthy subjects who required surgical removal of clinically as well as radiographically evident impacted lower wisdom teeth. The sample was subdivided into two groups of ten subjects each. The first group which is the control group included ten subjects where after removal of the tooth, local irrigation of socket was carried out with normal saline. The second group which is the trial group comprised ten subjects also, but in which tranexamic acid (injectable solution) in diluted form was used for local irrigation of socket. Both solutions were of equal amount. Estimation of amount of blood loss immediately following surgery was the criterion for comparison and was based on weight of gauze used before and after application over extraction socket. Results: The results showed a statistically significant decrease in the amount of blood loss in the trial group when compared with the control group. Conclusions: Tranexamic acid as commercially available or freshly prepared oral rinse may be used as an aid for the reduction or prevention of postoperative bleeding following the removal of third molars in healthy subjects as well as in patients with bleeding problems.

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