A nomogram to calculate the maximum dose of local anaesthetic in a paediatric dental setting

A simple calculation of the maximum dose of the local anesthetic in pediatric dentistry with nomogram in Serbian

Clinicians should identify the risks associated with the use of anesthetics and understand the maximum recommended doses of local anesthetics. Errors in calculating the dose of local anesthetics are common due to the widespread use of these agents. Different methods of calculating the dose of the drug have different advantages and disadvantages, and no method can guarantee a calculation without errors. Nomogram is a simple graphical tool on which one can read the result of arithmetic operations with given numbers. The nomogram for calculating the maximum dose of local anesthetic enables quick cross-checking of the calculation, based on the patient's age or body weight. They are of special importance in the application of local anesthesia in children.

Evaluation of Cytotoxicity and Taste-Masking Effect of Selected Flavors on Dental Lidocaine HCl Injection

AIM

Anxiety and intolerance to dental local anesthetic injections are common in patients undergoing dental procedures. This work was designed to study cytotoxicity of selected flavors in primary gingival keratinocytes (PGK), to acquire information on their suitability for use in dental lidocaine hydrochloride (LID) injection. We also evaluated the bio-mimetic taste of LID dental injection in the presence of selected flavors and sweetener using an Astree electronic tongue (ETongue).

METHODS

The cytotoxicity of chocolate natural and artificial flavor (CTE), raspberry flavor artificial (RAS), cherry flavor (CHR), bitterness suppressor flavor (BSF) and lemon flavor extract (LFE) at various dilutions (0.16-10% v/v) was carried out in PGK using the live cell morphological analysis and MTT cell cytotoxicity assay. Based on the cytotoxicity data, CTE and RAS were added to Xylocaine^® (2%) along with 0.09% sodium saccharin and taste was assessed using an ETongue.

RESULTS

After three hours of treatment, a dose-dependent cell death was induced by all flavors compared to the untreated control. BSF was found to be more toxic when compared to other flavors. CTE was found to be less toxic. The mean IC50 values of CTE, RAS, CHR, BSF and LFE in PGK were found to be 9.54, 8.43, 2.21, 0.38 and 4.01 mg/mL. Taste analysis with the ETongue showed a clear taste difference between the control and test formulations containing CTE and RAS flavors along with sodium saccharin.

CONCLUSION

CTE and RAS flavors in combination with 0.09% sodium saccharin can achieve a significant taste-masking effect in the dental LID injection.