[Importance of deontology in odontologic practice].
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OBJECTIVE: To investigate the changes of tooth pain in patients with orthodontic tooth movement, to study the changes of bioactivators in GCF in patients with orthodontic tooth movement, and explore the correlation between pain and bioactivators in orthodontic patients. METHODS: 50 patients were included, each having one treatment tooth and one contralateral control tooth. The levels of PGE(2), P substances, IL-6 and GM-CSF in GCF of upper lateral incisor were investigated before activation and at 12th hour, 24th hour, 48th hour and 72th hour after the applying labial orthodontic force, by using highly sensitive radioimmunassay. To record the changes of pain in orthodontic patients at 12th hour, 24th hour,48th hour and 72th hour after applying stress. RESULTS: At experimental sides, total amount of GCF PGE(2), P substances(SP), IL-6 and GM-CSF levels was significantly elevated compared with that before activation. The concentration of PGE(2) and SP in GCF increased significantly and reached peak point at 24th hour in patients, while the levels of IL-6 and GM-CSF in GCF remained at higher baseline through the experiment. There was an rhythm change of periodontal pain during orthodontic tooth movement. CONCLUSION: There was an rhythm changes of pain after stress in patients with orthodontic tooth movement, and the rhythm pain was correlated to the changes of some activator such as P substances and PGE(2) in periodontal ligament.
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OBJECTIVES: The aim of the present study was to investigate the incidence of barodontalgias in a sample of 506 patients, all of whom are personnel with responsibility in military flight. An additional aim was to correlate this incidence with various oral pathologies and their subsequent treatment. DESIGN OF THE STUDY: The ICAO and CPITN indices in flight personnel who underwent the obligatory official examination at the Straits Air Command Hospital were investigated, in each case taking the data of the initial examination. Any effects that occurred in simulated flights, conducted in a hypobaric chamber, were also recorded. Any case of barodontalgia was investigated in depth, relating it to the pathology that caused it, and observing the result of the treatment employed. RESULTS: There were three cases of barodontalgia (2.63%). The pain was essentially of posterior localisation (92.3%), and in the majority of cases was described as acute and localised (61.5%). In a high percentage it did not disappear after landing (61.5%). The pathologies were varied, and the treatments were in keeping with these. The result after the therapeutic phase was entirely satisfactory in 69.2%. If we correlate the appearance of barodontalgias with other variables, in the patients who experienced them we record a larger number of fillings (P = 0.1617) and a smaller number of teeth missing (P = 0.6603). The Caries Index is similar in the two groups (P = 0.9187). The average ICAO is higher (P = 0.3345) in those patients who suffered from pain, though it must be pointed out that the low number of cases means it is difficult to record statistically significant results. CONCLUSIONS: Our results showed an incidence of barodontalgia in the study population of 2.63%, overall. In real flight the incidence was 2.4% and in the ascents conducted in the hypobaric chamber it was 0.2%. On the other hand, no statistically significant differences were found between the results for the Indices of Oral Health of the patients affected by barodontalgia and those not so affected, although the ICAO was greater.
A variety of analgesic regimens can be developed, based on sound pharmacological principles, in response to the empirical estimate of pain intensity. Including optimal doses of nonopioids to reduce the amount of opioid required is recommended. Furthermore, when pain is anticipated, the nonopioid regimen can be administered on a regular schedule rather than as needed. Preventing pain is better than attempting to reduce it after full intensity has been reached. Careful selection of an effective regimen can prevent breakthrough pain, along with stress and anxiety, which are factors that often require desperate attempts for relief. Options for the dentist to consider are summarized in Table 5 and may be simulated through substitution of other NSAID or opioid equivalents.
To determine the effect of pressure variations on the retention of prosthetic crowns, 36 identical, cast metal crowns were fixed to simulated, epoxy resin crown preparations with zinc oxyphosphate cement. Eighteen specimens were placed in a hyperbaric chamber and subjected to 15 cycles of simulated immersion at 30 m and decompression, as usually carried out by scuba divers. The untreated specimens served as controls. When the force required to dislodge the crowns was measured, the treated crowns were dislodged at about one third the load that was required to dislodge the control group, indicating that a statistically significant decrease in cement strength follows pressure variations.