New Method of Sedation in Oral Surgery

2005 ◽  
Vol 31 (6) ◽  
pp. 304-308 ◽  
Author(s):  
Gintaras Juodzbalys ◽  
Rimvydas Giedraitis ◽  
Vita Mačhiulskienė ◽  
Luc W. J. Huys ◽  
Ricardas Kubilius

Abstract Local anesthesia, the well-known method of sedation, usually is insufficient for dental implantation and the augmentation of the alveolar ridge, because the operations last for 1 to 2 hours and patients may experience fear and strain. This article examines a new complex sedation method using ketorolac, midazolam, and a local anesthetic 4% solution of articaine hydrochloride and epinephrine (Septanest) in combination with a vasoconstrictor. This method was applied to 67 patients operated on for dental implantation with screw implants or for the alveolar ridge augmentation with biocompatible materials. The control group, which consisted of 20 patients, received local anesthesia with articaine-epinephrine only. Most of the control patients were found to have experienced fear and strain during the aforementioned surgical procedures; their blood pressure and pulse rate increased, and more than half of them experienced pain. No disorders of hemodynamics or the psychoemotional status of the patients were observed during sedation with ketorolac, midazolam, and articaine-epinephrine. Furthermore, anterograde amnesia was determined for the 80% of the patients in the test group.

Author(s):  
J. S. Hanker ◽  
B. L. Giammara

Nonresorbable sintered ceramic hydroxylapatite (HA) is widely employed for filling defects in jaw bone. The small particles used for alveolar ridge augmentation in edentulous patients or for infrabony defects due to periodontal disease tend to scatter when implanted using water or saline as the vehicle. Larger blocks of this material used for filling sockets after tooth extraction don't fit well. Studies in our laboratory where we compared bovine serum albumin, collagen and plaster of Paris as binders to prevent particle scatter during implantation suggested that plaster was most useful for this purpose. In addition to preventing scatter of the particles, plaster enables the formation of implants of any size and.shape either prior to or during surgery. Studies with the PATS reaction have indicated that plaster acts as a scaffold for the incorporation of HA particles into bone in areas where the implant contacts either host bone or periosteum. The shape and integrity of the implant is maintained by the plaster component until it is replaced over a period of days by fibrovascular tissue.


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