Minimizing problems in fitting, seating, and cementation of fixed prosthodontic retainers.
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The multifactorial nature of oral and facial pain was investigated by the collection of clinical and psychologic data from 312 patients with either dental pain, temporomandibular joint disorder, or atypical facial pain. Significant differences between the groups in gender and age distribution, muscle and joint pain, radiographic joint changes, number of remaining teeth, pain duration, and aspects of the patients' perception of pain were evident. In addition, discriminant function analysis clearly differentiated between the three groups on the basis of both clinical and psychologic variables, emphasizing the multifactorial nature of oral and facial pain.
Pulpal injury commonly occurs with tooth preparation for complete fixed partial dentures. This can be documented by the substantial incidence of pain after tooth preparation. In this study, a 4% potassium nitrate-zinc oxide eugenol temporary cement was used to secure provisional crowns over recently prepared teeth and it significantly reduced the incidence and severity of pain after tooth preparation and impression taking.
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The present study compared the potency of a range of alpha-adrenoceptor agonists in producing antinociception and sedation in the rat and dog. In the rat, the selective alpha 2-adrenoceptor agonists, guanabenz, UK 14304 and guanfacine, were more potent as sedative agents than as antinociceptive agents. For compounds which have similar activities at both alpha 1 and alpha 2-adrenoceptors, such as clonidine, alinidine, oxymetazoline and naphazoline, there was little separation between effective doses for antinociception and sedation. In marked contrast, the selective alpha 1-adrenoceptor agonists, ST 587 and methoxamine, were more potent as antinociceptive agents than as sedatives. Similarly, ICI 106,270 and CP 18,534, two agonists with a greater alpha 1 to alpha 2-adrenoceptor ratio than clonidine, were also more potent in antinociceptive tests than in sedative tests. In the conscious dog, clonidine was 8-10 times more potent than ICI 106,270 and CP 18,534 at increasing nociceptive thresholds to mild electrical stimulation of the toothpulp. At equi-antinociceptive doses, the ranked order of potency for inducing sedation was clonidine greater than or equal to ICI 106,270 greater than CP 18,534. Dose-related bradycardia was also induced by each of the three alpha-adrenoceptor agonists at antinociceptive doses. These data suggest that antinociceptive activity can probably be mediated by either alpha 1 or alpha 2-adrenoceptors, whereas sedation appears to be mediated solely by the alpha 2-subtype. Thus, it may be possible to separate the antinociceptive and sedative effects of sympathomimetic agents, but it is unlikely that these agents would be completely devoid of cardiovascular effects.
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A case is reported in which initial anginal pain was localized to the area of the left posterior teeth. Subsequently the patient reported that at certain times he experienced pain in the area of the left posterior teeth with concomitant chest pain while at other times the pain was confined to the teeth.
The clinical findings in thirty-five cases of periodic migrainous neuralgia (PMN) are given. Typical case histories are used to illustrate the fact that the condition may mimic dental pain. The nomenclature and association of the condition with migraine are briefly discussed, and a plea is made that the condition always be considered in cases of facial pain, when other clinical features of the disease are present, in order to save needless loss of teeth and delay in treatment.
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