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Gazal G, Omar E, Elmalky W. Rules of selection for a safe local anesthetic in dentistry. J Taibah Univ Med Sci 2023; 18:1195-1196. [PMID: 37234724 PMCID: PMC10205529 DOI: 10.1016/j.jtumed.2023.04.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2023] [Accepted: 04/24/2023] [Indexed: 05/28/2023] Open
Affiliation(s)
- Giath Gazal
- Department of Oral and Maxillofacial Surgery, Taibah University, Almadinah Almunawwarah, KSA
| | - Esam Omar
- Department of Oral and Maxillofacial Surgery, Taibah University, Almadinah Almunawwarah, KSA
| | - Wael Elmalky
- Department of Restorative, Dentistry, Taibah University, Almadinah Almunawwarah, KSA
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Gazal G, Elmalky W, Zafar MS. Conduct dental care for uncontrolled diabetic patients during COVID-19 pandemic. J Taibah Univ Med Sci 2023; 18:997-998. [PMID: 36811086 PMCID: PMC9934004 DOI: 10.1016/j.jtumed.2023.02.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Accepted: 02/08/2023] [Indexed: 02/18/2023] Open
Affiliation(s)
- Giath Gazal
- Department of Oral and Maxillofacial Surgery, Taibah University, Almadinah Almunawwarah, KSA
| | - Wael Elmalky
- Department of Restorative, Dentistry, Taibah University, Almadinah Almunawwarah, KSA
| | - Muhammad S. Zafar
- Department of Restorative, Dentistry, Taibah University, Almadinah Almunawwarah, KSA,Department of Dental Materials, Islamic International Dental College, Riphah International University, Islamabad, Pakistan,Corresponding address: Department of Restorative, Dentistry, Taibah University, Almadinah Almunawwarah, KSA
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Gazal G, Zafar MS. A new cause of the adrenal crisis in dental and medical patients: Opioid-induced adrenal insufficiency. J Taibah Univ Med Sci 2022; 18:427-428. [PMID: 36818183 PMCID: PMC9932560 DOI: 10.1016/j.jtumed.2022.11.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Accepted: 11/30/2022] [Indexed: 12/23/2022] Open
Affiliation(s)
- Giath Gazal
- Department of Oral and Maxillofacial Surgery, Taibah University, Almadinah Almunawwarah, KSA
| | - Muhammad S. Zafar
- Department of Restorative, Dentistry, Taibah University, Almadinah Almunawwarah, KSA,Corresponding address: Department of Restorative Dentistry, College of Dentistry, Taibah University, Almadinah Almunawwarah, 41311, KSA.
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Gazal G, Aljohani H, Al-Samadani KH, Nassani MZ. Measuring the Level of Medical-Emergency-Related Knowledge among Senior Dental Students and Clinical Trainers. Int J Environ Res Public Health 2021; 18:ijerph18136889. [PMID: 34198982 PMCID: PMC8297173 DOI: 10.3390/ijerph18136889] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/22/2021] [Revised: 06/17/2021] [Accepted: 06/23/2021] [Indexed: 11/16/2022]
Abstract
OBJECTIVES This study aimed to measure the level of medical-emergency-related knowledge among senior dental students and clinical trainers in Saudi Arabia. METHODS This cross-sectional pilot survey was conducted at Taibah Dental College, Madina, Saudi Arabia between March 2017 and November 2018. Two hundred and seventy-five self-administered anonymous questionnaires on the management of common medical emergencies were distributed to all senior dental students and clinical trainers at Taibah Dental College. RESULTS There was a serious lack of knowledge regarding the management of medical emergency scenarios among the participants. Only 54% of participants knew the correct management for some frequent and life-threating conditions such as "crushed chest pain", and only 30-35% of participants knew the correct management of deeply sedated patients with benzodiazepine overdose and crisis of hypoadrenalism. Moderate-quality knowledge (50-74% of participants responded correctly) was noted for the following conditions: sudden onset of brain stroke, psychiatric patient, unconscious patient with hypoglycemia, patient with postural hypotension, and patient with hyperventilation. Based on the scale of knowledge, there were significant differences in the level of knowledge between clinical trainers, senior dental students, and junior dental students (p ≤ 0.01). Almost all students and 90% of trainers declared the need for further training. CONCLUSIONS The overall knowledge regarding the management of medical emergency crises in the dental chair was moderate. However, the scale of knowledge regarding the management of medical emergency crises has gradually increased with the number of years of experience. Most participants recognize the need for further training.
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Affiliation(s)
- Giath Gazal
- Department of Oral and Maxillofacial Surgery, Taibah University, Al Madinah Al Munawwarah 41311, Saudi Arabia;
- Correspondence:
| | - Hamzah Aljohani
- Department of Oral and Maxillofacial Surgery, Taibah University, Al Madinah Al Munawwarah 41311, Saudi Arabia;
| | - Khalid H Al-Samadani
- Department of Restorative Dental Science, College of Dentistry, Taibah University, Al Madinah Al Munawwarah 41311, Saudi Arabia;
| | - Mohammad Zakaria Nassani
- Department of Restorative and Prosthetic Dental Sciences, College of Dentistry, Dar Al Uloom University, Riyadh 11512, Saudi Arabia;
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Gazal G. Does articaine, rather than prilocaine, increase the success rate of anaesthesia for extraction of maxillary teeth. Saudi J Anaesth 2020; 14:297-301. [PMID: 32934619 PMCID: PMC7458028 DOI: 10.4103/sja.sja_94_20] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2020] [Revised: 03/03/2020] [Accepted: 03/17/2020] [Indexed: 12/04/2022] Open
Abstract
Objective: To compare the anesthetic performances of 3% prilocaine and 4% articaine when used for the extraction of the maxillary teeth. Materials and Methods: Ninety-five patients, aged between 16 and 70 years, were included in this study. Patients were divided into two groups. Group one received articaine 4% with 1:00.000 adrenaline. Group two received prilocaine with 3% felypressin (0.03 I.U. per ml). Onset time of anesthesia was objectively evaluated by using electronic pulp testing. Results: Eighty-five patients in this study had a successful local anesthetic followed by extraction within the study duration time (10 minutes). However, there were six patients with failure anesthesia (5 in prilocaine group and 1 in articaine group). By applying Person's Chi-square test (x2), there were no significant differences in the number of episodes of the anesthetic success between articaine and prilocaine groups at time intervals (P = 0.5). T-test showed that there have been no important variations within the mean onset time of anesthesia for articaine and prilocaine buccal infiltrations (P = 0.1). Conclusions: 3% Prilocaine with felypressin is as effective as 4% articaine with adrenaline when used for the extraction of maxillary teeth. Recommendations would be given to the dental practitioners to use prilocaine more frequently than articaine because of its low toxicity. Trial registration number: NCT04236115.
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Affiliation(s)
- Giath Gazal
- Department of Oral and Maxillofacial Surgery, Taibah University, College of Dentistry, Madinah Al- Munawwarah, Saudi Arabia
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Gazal G. Overcoming temporomandibular joint clicking and pain. Cranio 2020; 38:209-211. [DOI: 10.1080/08869634.2020.1769440] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Affiliation(s)
- Giath Gazal
- College of Dentistry, Taibah University, Al Madina Al Munawara, Kingdom of Saudi Arabia
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Gazal G, Bahabri R, Alolayan AB, Alkayyal M, Al-Ghamdi R, Salamah R. How Successful is Supplemental Intraseptal and Buccal Infiltration Anaesthesia in the Mandibular Molars of Patients Undergoing Root Canal Treatment or Tooth Extraction? J Oral Maxillofac Res 2020; 11:e5. [PMID: 32377329 PMCID: PMC7191379 DOI: 10.5037/jomr.2020.11105] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2020] [Accepted: 03/17/2020] [Indexed: 11/16/2022]
Abstract
Objectives To investigate the success rate of supplemental intraseptal and buccal infiltration anaesthesia in mandibular molars undergoing endodontic therapy/extraction when the inferior alveolar nerve block has failed. Material and Methods A prospective clinical trial including 200 patients undergoing lower molar root canal treatment/teeth extraction was conducted. Only 80 patients of the participants who had profound lower lip anaesthesia after the administration of inferior alveolar nerve block (IANB) were in pain within treatment. Patients experiencing moderate to severe pain upon using elevators, forceps, bur, or endodontic file were randomly allocated to the 2% lidocaine intraseptal injection and 4% articaine buccal infiltration groups. Level of pain was assessed every 2 to 10 min on standard 100 mm visual analogue scales. Results Overall, 55 (69%) of patients who were given either intraseptal injection of 2% lidocaine or buccal infiltration of 4% articaine had successful anaesthesia of lower molar teeth within 10 min. However, 25 (31%) of participating patients in the buccal infiltration and the intraseptal groups had failed anaesthesia within the study duration (10 min), and they received additional local anaesthetic. IANBs were more painful than buccal and intraseptal injections. However, buccal articaine injections were significantly more comfortable than intraseptal lidocaine injections (P > 0.001). Conclusions Supplemental intraseptal injection of 2% lidocaine and buccal infiltration of 4% articaine achieved profound pulpal anaesthesia in 69% of patients when the inferior alveolar nerve block failed. Recommendations can be given to dental practitioners to use infiltration of 4% articaine in conjunction with intraseptal injection of 2% lidocaine to anaesthetize the lower molar teeth when inferior alveolar nerve block fails.
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Affiliation(s)
- Giath Gazal
- Department of Oral and Maxillofacial, College of Dentistry, Taibah University, MedinaKingdom of Saudi Arabia
| | - Rayan Bahabri
- Department of Restorative Dental Sciences, Division of Endodontics, College of Dentistry, Taibah University, MedinaKingdom of Saudi Arabia
| | - Albraa B Alolayan
- Department of Oral and Maxillofacial, College of Dentistry, Taibah University, MedinaKingdom of Saudi Arabia
| | - Mahmod Alkayyal
- College of Dentistry, Taibah University, MedinaKingdom of Saudi Arabia
| | - Rahaf Al-Ghamdi
- College of Dentistry, Taibah University, MedinaKingdom of Saudi Arabia
| | - Ruwaa Salamah
- College of Dentistry, Taibah University, MedinaKingdom of Saudi Arabia
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Gazal G, Omar E, Fareed WM, Alsharif A, Bahabri R. Impact of maxillary teeth morphology on the failure rate of local anesthesia. Saudi J Anaesth 2020; 14:57-62. [PMID: 31998021 PMCID: PMC6970379 DOI: 10.4103/sja.sja_542_19] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2019] [Accepted: 09/02/2019] [Indexed: 12/12/2022] Open
Abstract
Objective: To investigate the effect of maxillary single and multiple rooted teeth on the success rate of buccal infiltration anesthesia. Subjects and Methods: This clinical study was performed by dividing the participants into three groups. Group one included 30 patients with upper anterior teeth, group two 23 patients with upper premolars teeth and group three 39 patients with upper molars for extraction. Onset time of anesthtic action was evaluted by using electronic pulp tester. Pulp testing assessments were carried out immediately before the injection and at the intervals of 2 mins following the injection until the anesthetic success obtains. Results: Seventy-nine patients in this study secured anesthetic success within study duration time (10 min). However, there were 13 patients with dental anesthesia failures (3 patients with single rooted teeth and 10 patients with multiple rooted teeth). There were no significant differences in the mean onset time of pulpal anesthesia between the anterior, middle and posterior teeth (P value = 0.449). Clinically, patients with single rooted teeth reported faster dental anesthesia and earlier teeth extraction than patients with multiple rooted teeth. Conclusion: This study showed that the single rooted teeth have faster pulpal anesthesia and early extraction than teeth with multiple roots but not statistically significant. Administration of extra local anesthetic cartridge or using intraseptal injection technique can be a solution to overcome the failure of anesthesia in the maxillary posterior teeth.
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Affiliation(s)
- Giath Gazal
- Department of Oral and Maxillofacial Surgery, College of Dentistry, Taibah University, Madinah Al-Munawwarah, Kingdom of Saudi Arabia
| | - Esam Omar
- Department of Oral and Maxillofacial Surgery, College of Dentistry, Taibah University, Madinah Al-Munawwarah, Kingdom of Saudi Arabia
| | - Wamiq M Fareed
- Department of Oral and Maxillofacial Surgery, College of Dentistry, Taibah University, Madinah Al-Munawwarah, Kingdom of Saudi Arabia
| | - Ali Alsharif
- Department of Prosthodontics, College of Dentistry, Taibah University, Madinah Al-Munawwarah, Kingdom of Saudi Arabia
| | - Rayan Bahabri
- Department of Restorative Dentistry, College of Dentistry, Taibah University, Madinah Al-Munawwarah, Kingdom of Saudi Arabia
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Gazal G. Management of an emergency tooth extraction in diabetic patients on the dental chair. Saudi Dent J 2019; 32:1-6. [PMID: 31920272 PMCID: PMC6950840 DOI: 10.1016/j.sdentj.2019.07.004] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2019] [Revised: 07/04/2019] [Accepted: 07/27/2019] [Indexed: 02/08/2023] Open
Abstract
Background and objective Approximately 75% of diabetic patients in Saudi Arabia had poor glycaemic control. A high proportion of these patients will attend dental surgery clinics for treatment. Therefore, dentists should be well-prepared to control any complications they might arise on the dental chair during the dental procedures. Management of the associated risk factors is important to limit disease complications and improve the health of patients with diabetes.The objectives of this review were to determine the maximum acceptable level of blood glucose for tooth removal in diabetics, show a systematic technique for the management of patients with diabetes on the dental chair. By using PRISMA guidelines, analysis of the published articles and reports across the world is considered one of the most appropriate available methods to obtain strong evidence about the acceptable levels of blood glucose where teeth extraction can be done safely. Results A total of 1080 studies were retrieved using the search strategy. After screening 185 titles, abstracts and 85 full-text articles, 36 studies were included. The outcome of this systematic review revealed that fasting blood glucose level of 240 mg/dl is a critical point for any dental treatment because the warning signs of diabetes start coming out. Maximum acceptable levels of blood glucose for removal of teeth in diabetics are 180 mg/dl (before meal) and 234 mg/dl (2 h after a meal). High blood glucose levels reduce the secretion of nitric oxide (powerful vasodilator) in the body which leads to poor circulation and slow-healing socket. Uncontrolled diabetics are at high risk of infection because of the high ketone levels in the blood. Conclusion Fasting blood glucose level of 180 mg/dl is a cut-off point for any selective dental extraction. However, Random blood glucose level of 234 mg/dl (13 mmol/l) is a cut-off point for an emergency tooth extraction. Tightly controlled diabetic patients (blood glucose level below 70 mg/dl) are susceptible to hypoglycemia.
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Affiliation(s)
- Giath Gazal
- Department of Oral and Maxillofacial, Taibah University, Al Madinah Al Munawwarah, Kingdom of Saudi Arabia. E-mail.
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Abstract
Objectives: To investigate the potency and speed of action of 2% lidocaine and 3% prilocaine for upper teeth extractions. Methods: This prospective clinical study was conducted from November 2016 to May 2017. Ninety-six patients, aged between 16 to 70 years old were recruited in this study. Two regimens were randomly administered over one visit. Patients, treatment group I, received 2% lidocaine with 1:00.000 adrenaline. Patients treatment group II received prilocaine 3% and felypressin 0.03 I.U. per ml. The efficacy of pulp anesthesia was determined by electronic pulp testing. At any point of trial (10 minutes), the anesthetized tooth becomes unresponsive for maximal pulp stimulation (64 reading), the extraction was carried out. Results: There were no significant differences in the mean onset time of pulpal anesthesia and extraction between the prilocaine and lidocaine buccal infiltration groups (p=0.28). However, clinically, the patients in prilocaine group recorded faster onset time of anesthesia and teeth extraction than those in lidocaine group. Conclusion: Prilocaine has a better clinical performance in terms of providing rapid dental anesthesia and earlier teeth extraction than lidocaine but the differences were not significant. Prilocaine with felypressin could be a good choice for patients who have contraindication to the use of lidocaine with adrenaline.
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Affiliation(s)
- Giath Gazal
- Department of Oral and Maxillofacial, Taibah University, Al Madinah Al Munawwarah, Kingdom of Saudi Arabia. E-mail.
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Abstract
The harmful effects of khat chewing on the oral mucosa membrane are still uncertain. Verruca vulgaris (common warts) is a benign lesion of skin and mucous membranes and can be caused by human papillomavirus. The lesions are typically self-limited but may vary in size and number. The occurrence on the floor of mouth is extremely rare. To the best of our knowledge, there are few number of oral lesions reported in connection with khat users. This case report shows that the chronic khat chewing has contributed to the development of verruca vulgaris warts that were confined to the chewing side of the mouth. A rare case of verruca vulgaris of the floor of mouth occurring in a 27-year-old Yamani male is presented with a discussion on etiopathogenesis and the treatment methods. Verruca vulgaris must be remembered in the differential diagnosis of the floor of mouth lesions, and surgical treatment may provide satisfactory outcomes.
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Affiliation(s)
- G Gazal
- Department of Maxillofacial Surgery, College of Dentistry, Taibah University, Al Madinah Al Munawwarah, Saudi Arabia
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Abstract
OBJECTIVES To investigate the potency and speed of action of 2% lidocaine and 3% prilocaine for upper teeth extractions. METHODS This prospective clinical study was conducted from November 2016 to May 2017. Ninety-six patients, aged between 16 to 70 years old were recruited in this study. Two regimens were randomly administered over one visit. Patients, treatment group I, received 2% lidocaine with 1:00.000 adrenaline. Patients treatment group II received prilocaine 3% and felypressin 0.03 I.U. per ml. The efficacy of pulp anesthesia was determined by electronic pulp testing. At any point of trial (10 minutes), the anesthetized tooth becomes unresponsive for maximal pulp stimulation (64 reading), the extraction was carried out. Results: There were no significant differences in the mean onset time of pulpal anesthesia and extraction between the prilocaine and lidocaine buccal infiltration groups (p=0.28). However, clinically, the patients in prilocaine group recorded faster onset time of anesthesia and teeth extraction than those in lidocaine group. Conclusion: Prilocaine has a better clinical performance in terms of providing rapid dental anesthesia and earlier teeth extraction than lidocaine but the differences were not significant. Prilocaine with felypressin could be a good choice for patients who have contraindication to the use of lidocaine with adrenaline.
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Affiliation(s)
- Giath Gazal
- Department of Oral and Maxillofacial, Taibah University, Al Madinah Al Munawwarah, Kingdom of Saudi Arabia. E-mail.
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Abstract
Objective To investigate the speed of action and injection discomfort of 2% lidocaine and 3% prilocaine for upper teeth extractions. Materials and Methods Forty-six patients were included in the prilocaine 3% group, and 46 in the lidocaine 2% control group. After all injections, soft and hard tissue numbness was objectively gauged by dental probe at intervals of 15 s. Moreover, the pain of the injections was recorded by the patients after each treatment on standard 100 mm visual analog scales, tagged at the endpoints with "no pain" (0 mm) and "unbearable pain" (100 mm). Results There were no significant differences in the meantime of first numbness to associated buccal, palatal mucosa, and tooth of patients in the lidocaine and prilocaine buccal infiltration groups (P = 0.56, 0.37, and 0.33). However, clinically, the patients in prilocaine group recorded earlier buccal, palatal mucosa, and teeth numbness than those in lidocaine group. With regards to the discomfort of the needle injections, there was a significant difference for lidocaine and prilocaine groups when comparing the post buccal scores with the post palatal injection scores (t-test: P < 0.001). Lidocaine and prilocaine buccal injections were significantly more comfortable than palatal injections. Conclusions Using 2% lidocaine and 3% prilocaine for extractions of upper maxillary teeth produces similarly successful anesthesia. Clinically, prilocaine has slightly rapid onset of action, earlier buccal mucosa, hard palate, and teeth numbness. Prilocaine and lidocaine buccal injection was significantly more comfortable than palatal injection.
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Affiliation(s)
- Ali Alsharif
- Department of Oral and Maxillofacial, College of Dentistry, Taibah University, Medina, Kingdom of Saudi Arabia
| | - Esam Omar
- Department of Oral and Maxillofacial, College of Dentistry, Taibah University, Medina, Kingdom of Saudi Arabia
| | - Al-Braa Badr Alolayan
- Department of Oral and Maxillofacial, College of Dentistry, Taibah University, Medina, Kingdom of Saudi Arabia
| | - Rayan Bahabri
- Department of Restorative Dentistry, College of Dentistry, Taibah University, Medina, Kingdom of Saudi Arabia
| | - Giath Gazal
- Department of Oral and Maxillofacial, College of Dentistry, Taibah University, Medina, Kingdom of Saudi Arabia
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Abstract
OBJECTIVES To investigate the potency and speed of action of 4% articaine and 2% mepivacaine for maxillary teeth extractions. MATERIAL AND METHODS Ninety-four patients, aged between 16 to 70 years old, were recruited in this study. Two regimens were randomly administered over one visit. Patients of treatment group 1 received mepivacaine 2% with 1:100,000 adrenaline, whereas treatment group 2 - articaine 4% with 1:100,000 adrenaline. The onset time of pulp anaesthesia for maxillary teeth indicated for extraction was determined by electronic pulp testing. At any point of trial (10 minutes), the anesthetized tooth becomes unresponsive for maximal pulp stimulation (64 reading), the extraction was carried out. RESULTS In this study, 85 patients had successful local anaesthetic followed by extraction within the study duration time (10 min). However, 5 patients had failed dental extraction (4 in mepivacaine group and 1 in articaine group). Patients in the articaine buccal infiltration group recorded faster onset time of action regarding anaesthesia and teeth extraction than patients in mepivacaine buccal infiltration group (P = 0.03). CONCLUSIONS Articaine is an effective anaesthetic with a rapid onset, comparable to mepivacaine in infiltrative techniques used for maxillary teeth extraction. However, articaine has clinically achieved faster dental anaesthesia and earlier teeth extraction than mepivacaine. So, articaine can be the local anaesthetic of first choice in oral surgery.
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Affiliation(s)
- Giath Gazal
- Department of Oral and Maxillofacial Surgery, College of Dentistry, Taibah University, Madinah Al-MunawwarahSaudi Arabia.
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Gazal G, Al-Samadani KH. Comparison of paracetamol, ibuprofen, and diclofenac potassium for pain relief following dental extractions and deep cavity preparations. Saudi Med J 2017; 38:284-291. [PMID: 28251224 PMCID: PMC5387905 DOI: 10.15537/smj.2017.3.16023] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Objectives: To compare the effectiveness of different oral analgesics for relieving pain and distress in adults following the extraction of teeth and deep cavity preparations under local anesthesia. Methods: This randomized controlled study was conducted between November 2015 and May 2016. One hundred and twenty patients were randomly allocated to 3 groups. Forty patients were in the paracetamol (1 gram) group, 40 in the ibuprofen (400 mg) group and 40 in the diclofenac potassium (50 mg) group. Evaluation of the post extraction and deep cavity preparations pain was made by patients immediately postoperatively, 2, 4 and 6 hours postoperatively on standard 100 mm visual analogue scales (VAS). Furthermore, each patient was observed preoperatively and immediately postoperatively for signs of distress by using a 5 point face scale. Results: There were significant decreases in mean pain VAS scores for diclofenac potassium group compared to paracetamol and ibuprofen groups at 4 hours postoperatively (one-way Analysis of Variance: p=0.0001, p=0.001) and 6 hours postoperatively (p=0.04, p=0.005). Changes in distress scores from the preoperative score to the postoperative score were made using the paired sample t-test. There were significant decreases in distress scores between the preoperative and postoperative scores (p=0.0001). Conclusions: Diclofenac potassium was more effective than paracetamol or ibuprofen for reducing postoperative pain associated with tooth extraction and deep cavity preparation. Patients’ distress levels can be alleviated by using preemptive analgesics.
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Affiliation(s)
- Giath Gazal
- Department of Oral and Maxillofacial Surgery, College of Dentistry, Taibah University, Al Madinah Al Munawwarah, Kingdom of Saudi Arabia. E-mail.
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Gazal G, Alharbi R, Fareed WM, Omar E, Alolayan AB, Al-Zoubi H, Alnazzawi AA. Comparison of onset anesthesia time and injection discomfort of 4% articaine and 2% mepivacaine during teeth extractions. Saudi J Anaesth 2017; 11:152-157. [PMID: 28442952 PMCID: PMC5389232 DOI: 10.4103/1658-354x.203017] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
Objective: To investigate the speed of action and injection discomfort of 4% articaine and 2% mepivacaine for upper teeth extractions. Materials and Methods: Forty-five patients were included in the articaine 4% group, and 45 in the mepivacaine 2% control group. After all injections, soft and hard tissue numbness was objectively gauged by dental probe at intervals of 15 s. Furthermore, the discomfort of the injections were recorded by the patients after each treatment on standard 100 mm visual analog scales, tagged at the endpoints with “no pain” (0 mm) and “unbearable pain” (100 mm). Results: There were significant differences in the meantime of first numbness to associated palatal mucosa and tooth of patients between mepivacaine and articaine buccal infiltration (BI) groups P = 0.01 and 0.01. Patients in the articaine group recorded earlier palatal mucosa and teeth numbness than those in the mepivacaine group. With regards to the discomfort of the needle injections, palatal injection was significantly more painful than BI (t-test: P < 0.001). Articaine buccal injection was significantly more painful than mepivacaine buccal injection (t-test: P <0.001). However, articaine palatal injection was less painful than articaine BI. Clinically, anesthesia onset time was faster in anterior upper teeth than upper middle and posterior teeth. Conclusions: BIs with 4% articaine was faster in achieving palate and teeth anesthesia than 2% mepivacaine for extraction of upper maxillary teeth. Patients in mepivacaine BI and articaine palatal injection groups reported less pain with needle injection. Failure of anesthesia was noticeable with maxillary multiple-rooted teeth.
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Affiliation(s)
- Giath Gazal
- Department of Maxillofacial Surgery, College of Dentistry, Taibah University, Al Madinah Al Munawwarah, Saudi Arabia
| | - Rashdan Alharbi
- Department of Maxillofacial Surgery, College of Dentistry, Taibah University, Al Madinah Al Munawwarah, Saudi Arabia
| | - Wamiq Musheer Fareed
- Department of Maxillofacial Surgery, College of Dentistry, Taibah University, Al Madinah Al Munawwarah, Saudi Arabia
| | - Esam Omar
- Department of Maxillofacial Surgery, College of Dentistry, Taibah University, Al Madinah Al Munawwarah, Saudi Arabia
| | - Albraa Badr Alolayan
- Department of Maxillofacial Surgery, College of Dentistry, Taibah University, Al Madinah Al Munawwarah, Saudi Arabia
| | - Hassan Al-Zoubi
- Department of Orthodontics, College of Dentistry, Taibah University, Al Madinah Al Munawwarah, Saudi Arabia
| | - Ahmad A Alnazzawi
- Department of Prosthodontics, College of Dentistry, Taibah University, Al Madinah Al Munawwarah, Saudi Arabia
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Fareed WM, Tandon P, Ahmad Z E, Gazal G, Hussain Khan A, Zaidi T, Fatima A, Falraddadi IS. Efficacy of Blood and Its Products-boon for Oral Surgeons: Review. ACTA ACUST UNITED AC 2017. [DOI: 10.21767/2254-6758.100071] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Abstract
Objectives: To investigate the effectiveness of topical anesthetic, 20% benzocaine in relieving pain and stress in patients following deep cavity restoration and extraction of teeth under local anesthesia (LA). Methods: A prospective clinical trial was conducted from October 2014 until April 2015 at Taibah University, Al Madinah Al Munawarah, Kingdom of Saudi Arabia. Forty-five patients were included in the 20% benzocaine group, and 46 in the normal saline group. Evaluation of the dental stress was made pre-operatively and immediately post-operative treatment using the visual analogue scale (VAS). Furthermore, discomfort of the injections were recorded by the patients after each treatment on standard 100 mm VAS, tagged at the endpoints with “no pain” (0 mm) and “unbearable pain” (100 mm). Results: There were statistically significant differences between the mean stress scores for patients in the benzocaine and normal saline groups post-operatively (p=0.002). There were significant differences between the mean pain scores for patients in the post buccal injection (p=0.001), post palatal injection (p=0.01), and the post inferior alveolar nerve block groups (p=0.02). Buccal, palatal, and inferior alveolar nerve block injections were more painful for patients in the normal saline group than the benzocaine group. Conclusion: This investigation has demonstrated that post-operative stress associated with deep cavity restoration and dental extractions under LA can be reduced by the application of topical anesthetic (20% benzocaine) at the operative site for intra-oral injections.
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Affiliation(s)
- Khalid H Al-Samadani
- Department of Restorative Dentistry, College of Dentistry, Taibah University, Al Madinah Al Munawarah, Kingdom of Saudi Arabia. E-mail.
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Gazal G, Tola AW, Fareed WM, Alnazzawi AA, Zafar MS. A randomized control trial comparing the visual and verbal communication methods for reducing fear and anxiety during tooth extraction. Saudi Dent J 2016; 28:80-5. [PMID: 27486293 PMCID: PMC4957266 DOI: 10.1016/j.sdentj.2015.11.001] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2014] [Revised: 10/26/2015] [Accepted: 11/16/2015] [Indexed: 12/21/2022] Open
Abstract
PURPOSE To evaluate the value of using the visual information for reducing the level of dental fear and anxiety in patients undergoing teeth extraction under LA. METHODS A total of 64 patients were indiscriminately allotted to solitary of the study groups following reading the information sheet and signing the formal consent. If patient was in the control group, only verbal information and routine warnings were provided. If patient was in the study group, tooth extraction video was showed. The level of dental fear and anxiety was detailed by the patients on customary 100 mm visual analog scales (VAS), with "no dental fear and anxiety" (0 mm) and "severe dental distress and unease" (100 mm). Evaluation of dental apprehension and fretfulness was made pre-operatively, following visual/verbal information and post-extraction. RESULTS There was a substantial variance among the mean dental fear and anxiety scores for both groups post-extraction (p-value < 0.05). Patients in tooth extraction video group were more comfortable after dental extraction than verbal information and routine warning group. For tooth extraction video group there were major decreases in dental distress and anxiety scores between the pre-operative and either post video information scores or postoperative scores (p-values < 0.05). Younger patients recorded higher dental fear and anxiety scores than older ones (P < 0.05). CONCLUSION Dental fear and anxiety associated with dental extractions under local anesthesia can be reduced by showing a tooth extraction video to the patients preoperatively.
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Affiliation(s)
- Giath Gazal
- Department of Oral and Maxillofacial Surgery, College of Dentistry, Taibah University, Al Madinah Al Munawwarah, Saudi Arabia
| | - Ahmed W Tola
- Department of Oral and Maxillofacial Surgery, College of Dentistry, Taibah University, Al Madinah Al Munawwarah, Saudi Arabia
| | - Wamiq M Fareed
- Department of Oral and Maxillofacial Surgery, College of Dentistry, Taibah University, Al Madinah Al Munawwarah, Saudi Arabia
| | - Ahmad A Alnazzawi
- Department of Prosthodontics, College of Dentistry, Taibah University, Al Madinah Al Munawwarah, Saudi Arabia
| | - Muhammad S Zafar
- Department of Restorative Dentistry, College of Dentistry, Taibah University, Al Madinah Al Munawwarah, Saudi Arabia
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21
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Abstract
Pain control during the dental procedure is essentials and challenging. A complete efficacious pulp anesthesia has not been attained yet. The regional anesthesia such as inferior alveolar nerve block (IANB) only does not guarantee the effective anesthesia with patients suffering from irreversible pulpitis. This main aim of this review was to discuss various aspects of intraseptal dental anesthesia and its role significance in pain-free treatment in the dental office. In addition, reasons of failure and limitations of this technique have been highlighted. Literature search was conducted for peer-reviewed articles published in English language in last 30 years. Search words such as dental anesthesia, pain control, intraseptal, and nerve block were entered using a web of knowledge and Google scholar databases. Various dental local anesthesia techniques were reviewed. A combination of block anesthesia, buccal infiltration and intraligamentary injection resulted in deep anesthesia (P = 0.003), and higher success rate compared to IANB. For pain-free management of conditions such as irreversible pulpitis, buccal infiltration (4% articaine), and intraosseous injection (2% lidocaine) are better than intraligamentary and IANB injections. Similarly, nerve block is not always effective for pain-free root canal treatment hence, needing supplemental anesthesia. Intraseptal anesthesia is an efficient and effective technique that can be used in maxillary and mandibular adult dentition. This technique is also beneficial when used in conjunction to the regional block or local dental anesthesia.
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Affiliation(s)
- G Gazal
- Department of Oral Surgery, College of Dentistry, Taibah University, Al Madinah Al Munawwarah, Saudi Arabia
| | - W M Fareed
- Department of Oral Surgery, College of Dentistry, Taibah University, Al Madinah Al Munawwarah, Saudi Arabia
| | - M S Zafar
- Department of Restorative Dentistry, College of Dentistry, Taibah University, Al Madinah Al Munawwarah, Saudi Arabia
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Gazal G, Alharbi AM, Al-Samadani KH, Kanaa MD. Articaine and mepivacaine buccal infiltration in securing mandibular first molar pulp anesthesia following mepivacaine inferior alveolar nerve block: A randomized, double-blind crossover study. Saudi J Anaesth 2015; 9:397-403. [PMID: 26543456 PMCID: PMC4610083 DOI: 10.4103/1658-354x.159463] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Aims: A crossover double-blind, randomized study was designed to explore the efficacy of 2% mepivacaine with 1:100,000 adrenaline buccal infiltration and 4% articaine with 1:100,000 adrenaline buccal infiltration following 2% mepivacaine with 1:100,000 adrenaline inferior alveolar nerve block (IANB) for testing pulp anesthesia of mandibular first molar teeth in adult volunteers. Materials and Methods: A total of 23 healthy adult volunteers received two regimens with at least 1-week apart; one with 4% articaine buccal infiltration and 2% mepivacaine IANB (articaine regimen) and another with 2% mepivacaine buccal infiltration supplemented to 2% mepivacaine IANB (mepivacaine regimen). Pulp testing of first molar tooth was electronically measured twice at baseline, then at intervals of 2 min for the first 10 min, then every 5 min until 45 min postinjection. Anesthetic success was considered when two consecutive maximal stimulation on pulp testing readings without sensation were obtained within 10 min and continuously sustained for 45 min postinjection. Results: In total, the number of no sensations to maximum pulp testing for first molar teeth were significantly higher after articaine regimen than mepivacaine during 45 min postinjection (267 vs. 250 episodes, respectively, P < 0.001), however, both articaine and mepivacaine buccal infiltrations are equally effective in securing anesthetic success for first molar pulp anesthesia when supplemented to mepivacaine IANB injections (P > 0.05). Interestingly, volunteers in the articaine regimen provided faster onset and longer duration (means 2.78 min, 42.22 min, respectively) than mepivacaine regimen (means 4.26 min, 40.74 min, respectively) for first molar pulp anesthesia (P < 0.001). Conclusions: Supplementary mepivacaine and articaine buccal infiltrations produced similar successful first molar pulp anesthesia following mepivacaine IANB injections in volunteers. Articaine buccal infiltration produced faster onset and longer duration than mepivacaine buccal infiltration following mepivacaine IANB injections.
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Affiliation(s)
- Giath Gazal
- Department of Oral and Maxillofacial, College of Dentistry, Taibah University, Medina, Saudi Arabia
| | - Abdullah Muteb Alharbi
- Department of Oral and Maxillofacial, College of Dentistry, Taibah University, Medina, Saudi Arabia
| | | | - Mohammad Dib Kanaa
- Department of Oral and Maxillofacial Surgery, Kettering General Hospital, Kettering, NN16 8UZ, United Kingdom
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Gazal G. Comparison of speed of action and injection discomfort of 4% articaine and 2% mepivacaine for pulpal anesthesia in mandibular teeth: A randomized, double-blind cross-over trial. Eur J Dent 2015; 9:201-206. [PMID: 26038650 PMCID: PMC4439846 DOI: 10.4103/1305-7456.156811] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Objective: To compare the injection pain and speed of local anesthetic effect induced by tissue infiltration of mepivacaine 2% with epinephrine 1:100,000 versus articaine 4% with epinephrine 1:100,000 in securing mandibular first molar pulp anesthesia. Materials and Methods: Totally, 25 patients were recruited in a crossover, randomized, double-blind study. Each subject received injections of mepivacaine 2% with epinephrine 1:100,000 as inferior alveolar nerve block (IANB) supplemented with either articaine 4% with epinephrine 1:100,000 (septocaine) or mepivacaine 2% buccal infiltration (BI) injection on two visits. The time of first numbness to associated lip, tongue and tooth was recorded by asking the participant directly and using electrical pulp tester. Anesthetic success was considered when two consecutive maximal stimulation on pulp testing readings without sensation. The patients rated the pain of infiltration using a 100 mm visual analog scale immediately after receiving each injection. The pain scores were compared using the paired t-test. Results: There were significant differences in the meantime of first numbness to associated lip and tooth of volunteers between mepivacaine and articaine BI groups P = 0.03 and 0.002. Volunteers in articaine group recorded earlier lip and teeth numbness than those in mepivacaine group. There were significant differences between the mean pain scores for volunteers in the post IANB and postbuccal injection groups (t-test: P <0.001). Mepivacaine IANB injection was significantly more painful than articaine/mepivacaine buccal injection. Conclusions: About 4% articaine was faster than 2% mepivacaine (both with 1:100,000 adrenaline) in anesthetizing the pulps of lower molar teeth after BIs. Earlier lip and teeth numbness were recorded in articaine group. Articaine and mepivacaine BIs were more comfortable than mepivacaine IANB injections.
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Affiliation(s)
- Giath Gazal
- Department of Oral and Maxillofacial Surgery, College of Dentistry, Taibah University, Almadinah Almunawwarrah, Kingdom of Saudi Arabia
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24
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Khaja AH, Ali Zwiad A, Tarakji B, Gazal G, Albaba F, KalajI N, Petro W. The Dependence on Smokeless Tobacco in the South Asian Communities in East London. Glob J Health Sci 2015; 8:194-8. [PMID: 26234985 PMCID: PMC4803994 DOI: 10.5539/gjhs.v8n1p194] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2015] [Accepted: 03/26/2015] [Indexed: 11/16/2022] Open
Abstract
Background & Objective: The purpose of the study was to understand the dependency on smokeless tobacco. Methods: The major aspect of the interview was to study the type of chewing tobacco used, frequency of purchase of chewing tobacco, change in attitude and behavior after the use of chewing tobacco. This study was done in 2005 in London. Of the 110 respondents interviewed 88 were used for the data analysis. Study Design: An exploratory study was conducted in East London, United Kingdom. The selected sample was interviewed through a questionnaire, based on the Severson Smokeless Tobacco Dependence Scale. Results: Cross tabulations report that in a sample of 88 South Asian UK resident men 46.6% used leaf (paan), 43.2% used processed form of chewing tobacco and 10.2% used gutka. Older age (67%) respondents were more likely than the younger age (30%) respondents to chew tobacco. The frequency of purchase of chewing tobacco is reported high (67.2%) in the older age group than the younger age group (50%). Conclusion: This current study used an amended form of the Severson Smokeless Tobacco Scale questionnaire to study the dependency on smokeless tobacco. The study could be developed in the selection of the sample, which would include both males and females to study the dependency on smokeless tobacco.
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Tarakji B, Gazal G, Al-Maweri SA, Azzeghaiby SN, Alaizari N. Guideline for the diagnosis and treatment of recurrent aphthous stomatitis for dental practitioners. J Int Oral Health 2015; 7:74-80. [PMID: 26028911 PMCID: PMC4441245] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2014] [Accepted: 02/25/2015] [Indexed: 11/06/2022] Open
Abstract
Recurrent aphthous stomatitis (RAS) is a well-known oral disease with unclear etiopathogenesis for which symptomatic therapy is only available. This kind of study aimed to highlight the main points that the general practitioners should be taken in their consideration. We have collected our data from PubMed line from 1972 to 2011. Our criteria included the papers that refer to the general predisposing factors, and the general treatment of RAS. Some papers which indicated to the specific details related to RAS that needed a consultant or specialist in Oral Medicine have not included. There is no clear guideline of the etiology, diagnosis, and management of RAS; therefore, the majority of the general practitioners refer most of the cases to appropriate specialist.
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Affiliation(s)
- Bassel Tarakji
- Head, Department of Oral Maxillofacial Sciences, Al-Farabi Colleges, Riyadh, Kingdom of Saudi Arabia,Correspondence: Dr. Tarakji B.Department of Oral Maxillofacial Sciences, Alfarabi Colleges, Riyadh, Kingdom of Saudi Arabia. Fax: +966-2324580.
| | - Giath Gazal
- Assistant Professor, Department of Oral and Maxillofacial Surgery, College of Dentistry, Taibah University, Al Madina Al Munawara, 41311, Kingdom of Saudi Arabia
| | - Sadeq Ali Al-Maweri
- Head, Department of Oral Maxillofacial Sciences, Al-Farabi Colleges, Riyadh, Kingdom of Saudi Arabia
| | - Saleh Nasser Azzeghaiby
- Head, Department of Oral Maxillofacial Sciences, Al-Farabi Colleges, Riyadh, Kingdom of Saudi Arabia
| | - Nader Alaizari
- Head, Department of Oral Maxillofacial Sciences, Al-Farabi Colleges, Riyadh, Kingdom of Saudi Arabia
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26
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Al-Maweri SA, Tarakji B, Al-Sufyani GA, Al-Shamiri HM, Gazal G. Lip and oral lesions in children with Down syndrome. A controlled study. J Clin Exp Dent 2015; 7:e284-8. [PMID: 26155347 PMCID: PMC4483338 DOI: 10.4317/jced.52283] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2014] [Accepted: 02/05/2015] [Indexed: 11/18/2022] Open
Abstract
Background Down syndrome (DS) is the most common chromosomal abnormality affecting numerous organs, including the orofacial region. The objective of the present study was to assess the prevalence of lip and oral soft tissue lesions, with particular emphasize on the incidence of fissured tongue, lip fissures and angular cheilitis, among individuals with DS in Yemen. Material and Methods This controlled cross-sectional study included 50 children with DS (6-18 years), and 50 age-and gender-matched healthy controls. The prevalence of orofacial soft tissue lesions was evaluated in both groups. Data were analyzed by Chi-square and Fisher tests, and p < 0.05 was considered to be statistically significant. Results Ten orolabial lesions were identified among the subjects. The most frequently seen lesions were: Fissured tongue (78.0%), lip fissures (64.0%), angular cheilitis (38.0%) and Cheilitis (14.0%). The frequencies of these lesions were significantly higher in children with DS than healthy controls (P< 0.001). Most of lip fissures were in the lower lip, and 80% of the fissures were in the midline. Conclusions The prevalence of lip and oral lesions among individuals with DS is remarkably high. Hence, oral physicians should be more aware of the orofacial findings seen more frequently in this genetic disorder. Key words:Down syndrome, lesions, lips, oral.
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Affiliation(s)
- Sadeq-Ali Al-Maweri
- Assistant Professor, Department of Oral and Maxillofacial Sciences, Al-Farabi Colleges of Dentistry and Nursing, Saudi Arabia; Department of Oral Medicine and Diagnosis, Sana'a University, Yemen
| | - Bassel Tarakji
- Professor, Head Department of Oral and Maxillofacial Sciences, Al-Farabi Colleges of Dentistry and Nursing,, Saudi Arabia
| | | | - Hashem M Al-Shamiri
- Lecturer, Department of Oral and Maxillofacial Sciences, Al-Farabi Colleges of Dentistry and Nursing
| | - Giath Gazal
- Assistant Professor, Department of Oral Maxillofacial Sciences, College of Dentistry, Taibah University
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Abstract
Objectives: This study was aimed to assess the impacts of delay treatment of mandibular fracture and its complications. In addition risk variables related such as time to repair, fracture types, substance abuse, causes, surgical management, muddling or complications and duration of clinic stay were also evaluated. Materials and Methods: The data of patients attending the Newcastle General Hospital, UK for the management of mandibular fractures were probed. This retrospective clinical trial conducted over 6 months, included 91 patients attending trauma operating theatre during weekdays or weekends. Data were analyzed for time to admission and treatment and its relationships to various factors using SPSS version 20 (SPSS Inc., Chicago, IL). Results: Time to treatment from the point of admission was 31.50 ± 3.83 h during week days that has been significantly more for patients attending the hospital at weekends or nights. Similar trend was observed for total summative time from the incident to treatment analysis. Conclusions: This investigation has demonstrated that the rate of infection and postoperative complications following surgical treatment of mandible fractures can be eased off by reducing the waiting time from presentation to the emergency and to the operating theater.
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Affiliation(s)
- Giath Gazal
- Department of Oral and Maxillofacial Surgery, College of Dentistry, Taibah University, Almadinah Almunawwarah, Saudi Arabia
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28
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Tarakji B, Umair A, Babaker Z, Sn A, Gazal G, Sarraj F. Relation between psoriasis and geographic tongue. J Clin Diagn Res 2015; 8:ZE06-7. [PMID: 25584342 DOI: 10.7860/jcdr/2014/9101.5171] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2014] [Accepted: 07/01/2014] [Indexed: 11/24/2022]
Abstract
The aim this article is to investigate the link between geographic tongue and psoriasis skin disease. Our review paper of the literature will handle strict study about the relation between geographic tongue and psoriasis. Our search has identified only limited studies available in English written literature starting from 2006-2013 using pubMed - indexed for MEDLINE. The result of this review suggests that geographic tongue may be an oral manifestation of psoriasis.There is no clear evidence in literature about association with gender and aetiology except one study which shows that benign migratory glossitis is more prevalent in young, nonsmoker and atopic or allergic individuals. Treatment for oral lesions is not standardized. A geographic tongue is significantly more frequent in psoriatic patients but only a limited data is available to date to strongly validate the association between these two entities.We recommend the general practitioner to have a good understanding about the clinical presentation, pathogenesis, diagnosis and treatment of this lesion. Psoriatic patients should be encouraged to undergo routine dental checkups.
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Affiliation(s)
- Bassel Tarakji
- Faculty, Department of Oral Maxillofacial Sciences, Al-Farabi College of Dentistry and Nursing , Riyadh
| | - Ayesha Umair
- Faculty, Department of Oral Maxillofacial Sciences, Al-Farabi College of Dentistry and Nursing , Riyadh
| | - Zynab Babaker
- Faculty, Department of Oral Maxillofacial Sciences, Al-Farabi College of Dentistry and Nursing , Riyadh
| | - Azzeghaiby Sn
- Director, Director of Alfarabi College of Dentistry and Nursing , Riyadh
| | - Giath Gazal
- Assistant Professor, Department of Oral Maxillofacial Sciences, College of Dentistry , Taibah University
| | - Faysal Sarraj
- Faculty, Oral Medicine Department, Faculty of Dentistry, University of Aleppo
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Gazal G, Fareed WM, Zafar MS. Effectiveness of gaseous and intravenous inductions on children's anxiety and distress during extraction of teeth under general anesthesia. Saudi J Anaesth 2015; 9:33-6. [PMID: 25558196 PMCID: PMC4279347 DOI: 10.4103/1658-354x.146282] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Context: Anxiety and distress regarding dental treatment is a major issue for dental patients and can be exaggerated in pediatric dental patients. Aims: The aim was to investigate how different methods of induction for general anesthesia affect children's distress for dental procedures such as extraction of teeth. Subjects and Methods: This was an observational clinical study conducted at Manchester University Dental Hospital. The induction of anesthesia in children was achieved with either intravenous (I.V.) or a gaseous induction. The Modified Child Smiley Faces Scales were completed for children at various times intervals. Statistical Analysis Used: There were statistically significant differences between the mean distress scores for the I.V. and inhalation groups (P values from independent t-test: P < 0.001) was applied. Results: In gaseous induction group, the number of children who scored severe and very severe distress was greater than those who were in I.V. group. Gaseous induction was used for 23 children. Preoperatively, 56.5% children were in very severe distress, 17.4% in severe distress, 13% in moderate distress, 8.7% in mild distress and only one (4.3%) showed no distress. For I.V. induction, 11.2% children were in very severe distress, 9% in severe distress, and 9.6% in moderate distress, 24.2% in mild distress and 46.1% showed no distress. Conclusions: Gaseous induction anesthesia for extractions of teeth does produce high levels of distress than I.V. induction in children for dental extractions. There was no significant difference between both induction methods in terms of distress levels at the time of recovery and 15 min postoperatively.
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Affiliation(s)
- Giath Gazal
- Department of Restorative Dental Sciences, College of Dentistry, Taibah University, Al Madinah Al Munawwarah, Saudi Arabia
| | - Wamiq M Fareed
- Department of Restorative Dental Sciences, College of Dentistry, Taibah University, Al Madinah Al Munawwarah, Saudi Arabia
| | - Muhammad S Zafar
- Department of Restorative Dental Sciences, College of Dentistry, Taibah University, Al Madinah Al Munawwarah, Saudi Arabia
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Gazal G, Fareed WM, Zafar MS, Al-Samadani KH. Pain and anxiety management for pediatric dental procedures using various combinations of sedative drugs: A review. Saudi Pharm J 2014; 24:379-85. [PMID: 27330369 PMCID: PMC4908057 DOI: 10.1016/j.jsps.2014.04.004] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2014] [Accepted: 04/19/2014] [Indexed: 11/05/2022] Open
Abstract
For fearful and uncooperative children behavioral management techniques are used. In order to control the pain and anxiety in pedodontic patients, pharmacologic sedation, anesthesia and analgesia are commonly used. Midazolam is commonly used as an oral sedation agent in children; it has several features such as safety of use, quick onset and certain degree of amnesia that makes it a desirable sedation agent in children. This review paper discusses various aspects of oral midazolam, ketamine and their combinations in conscious sedation including, advantages of oral route of sedation, pharmacokinetics, range of oral doses, and antagonists for clinical dental treatment procedures.
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Affiliation(s)
- Giath Gazal
- Department of Oral and Maxillofacial Surgery, College of Dentistry, Taibah University, P.O. Box 2898, Al Madinah Al Munawwarah, Saudi Arabia
| | - Wamiq Musheer Fareed
- Department of Oral and Maxillofacial Surgery, College of Dentistry, Taibah University, P.O. Box 2898, Al Madinah Al Munawwarah, Saudi Arabia
| | - Muhammad Sohail Zafar
- Department of Restorative Dentistry, College of Dentistry, Taibah University, P.O. Box 2898, Al Madinah Al Munawwarah, Saudi Arabia
| | - Khalid H Al-Samadani
- Department of Restorative Dentistry, College of Dentistry, Taibah University, P.O. Box 2898, Al Madinah Al Munawwarah, Saudi Arabia
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Mansuri S, Abdulkhayum AM, Gazal G, Hussain MAZ. Treatment of mandibular angle fracture with a 2mm, 3 dimensional rectangular grid compression miniplates: A prospective clinical study. J Int Oral Health 2013; 5:93-100. [PMID: 24453452 PMCID: PMC3895725] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2013] [Revised: 09/18/2013] [Accepted: 10/18/2013] [Indexed: 06/03/2023] Open
Abstract
BACKGROUND Surgical treatment of fracture mandible using an internal fixation has changed in the last decades to achieve the required rigidity, stability and immediate restoration of function. The aim of the study was to do a Prospective study of 10 patients to determine the efficacy of rectangular grid compression miniplates in mandibular fractures. MATERIALS & METHODS This study was carried out using 2.0 rectangular grid compression miniplates and 8 mm multidirectional screws as a rigid internal fixation in 10 patients without post operative intermaxillary fixation (IMF). Follow up was done for period of 6 months. RESULTS All fractures were healed with an absolute stability in post operative period. None of the patient complained of post operative difficulty in occlusion. CONCLUSION Within the limits of this study, it can be concluded that rectangular grid compression miniplates was rigid, reliable and thus can be recommended for the treatment of mandibular angle fractures. How to cite this article: Mansuri S, Abdulkhayum AM, Gazal G, Hussain MA. Treatment of mandibular angle fracture with a 2mm, 3 dimensional rectangular grid compression miniplates: A prospective clinical study. J Int Oral Health 2013;5(6):93-100 .
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Affiliation(s)
- Samir Mansuri
- Department of Maxillofacial Surgery, College of Dentistry, Taibah University, Al-Madina Al-Munawwarah, Kingdom of Saudi Arabia
| | | | - Giath Gazal
- Department of Maxillofacial Surgery, College of Dentistry, Taibah University, Al-Madina Al-Munawwarah, Kingdom of Saudi Arabia
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Gazal G, Mackie IC. A comparison of paracetamol, ibuprofen or their combination for pain relief following extractions in children under general anaesthesia: a randomized controlled trial. Int J Paediatr Dent 2007; 17:169-77. [PMID: 17397460 DOI: 10.1111/j.1365-263x.2006.00806.x] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
OBJECTIVE This study was designed to compare the effectiveness of different oral analgesics for relieving pain and distress in children following the extraction of teeth under general anaesthesia (GA). The analgesics included paracetamol alone, ibuprofen alone, and paracetamol and ibuprofen in combination. METHODS Two hundred and one subjects were randomly allocated to one of four groups. Forty-seven children were included in the ibuprofen alone (5 mg kg(-1)) group, 51 in the paracetamol/ibuprofen combination (15/5 mg kg(-1)) group, 48 in the high-dose paracetamol (20 mg kg(-1)) group, and 55 children were included in the usual-dose paracetamol (15 mg kg(-1)) group (control group). Evaluation of distress for children was made immediately pre-operatively, on recovery from anaesthesia and again after 15 min by using a five-point face scale. Furthermore, each child was observed immediately postoperatively and 15 min postoperatively for signs of pain using the Children's Hospital of Eastern Ontario Pain Scale. RESULTS There were significant decreases in the mean pain and distress scores for both the ibuprofen alone and paracetamol/ibuprofen combination groups compared to the control group (usual-dose paracetamol) at 15 min postoperatively. CONCLUSIONS This study provides evidence to support the oral administration of ibuprofen alone or in combination with paracetamol for postoperative analgesia in children who are having teeth extracted under GA.
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Affiliation(s)
- Giath Gazal
- Unit of Paediatric Dentistry, School of Dentistry, University of Manchester, Manchester, UK
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Gazal G, Mackie IC. Distress related to dental extraction for children under general anaesthesia and their parents. Eur J Paediatr Dent 2007; 8:7-12. [PMID: 17359208] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/14/2023]
Abstract
AIM The aims of this study were to observe levels of distress in children and their parents before and after extractions under general anaesthesia (GA) and to assess the effect of age, gender and the number of extractions on distress. DESIGN a randomized comparative trial. Setting University Dental Hospital of Manchester. SUBJECTS AND METHODS Two hundred and one children, together with their parents took part in this study. Immediately before GA, the Modified Child Smiley Faces Scales (MCSFS) and Modified Adult Smiley Faces Scales (MASFS) were completed by a trained observer for children and accompanying parents respectively, and again on recovery from anaesthesia and 15 minutes postoperatively. RESULTS There were generalised increases in mean distress scores for children when comparing the pre-operative with the postoperative scores. However, mean distress scores for parents reduced at recovery and 15 minutes postoperatively and were less than the mean distress scores for children. There was no correlation between the child and parent distress scores preoperatively, postoperatively and 15 minutes postoperatively. There were significant increase in median distress scores for younger children compared to the older children at recovery and 15 minutes postoperatively (P0.05). Children who had 8 - 14 teeth extracted demonstrated higher levels of distress than those who had 1 - 7 teeth extracted (P0.05). CONCLUSION Extraction of teeth under general anaesthesia does produce distress in children and their parents. Child and parental distress were not related. Both age and number of teeth extracted appear to influence the level of distress in children.
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Affiliation(s)
- G Gazal
- Unit of Oral Surgery, School of Dentistry, University of Aleppo, Syria
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Coulthard P, Rolfe S, Mackie I, Gazal G, Morton M, Jackson-Leech D. Intraoperative local anaesthesia for paediatric postoperative oral surgery pain – a randomized controlled trial. Int J Oral Maxillofac Surg 2006; 35:1114-9. [DOI: 10.1016/j.ijom.2006.07.007] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2006] [Revised: 06/08/2006] [Accepted: 07/05/2006] [Indexed: 10/24/2022]
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Gazal G, Bowman R, Worthington HV, Mackie IC. A double-blind randomized controlled trial investigating the effectiveness of topical bupivacaine in reducing distress in children following extractions under general anaesthesia. Int J Paediatr Dent 2004; 14:425-31. [PMID: 15525311 DOI: 10.1111/j.1365-263x.2004.00587.x] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVE This study was designed to investigate the effectiveness of topical bupivacaine (0.25%) in reducing postoperative distress following extraction of teeth under general anaesthesia in children. DESIGN The study was a double-blind randomized controlled trial. SETTING The study was conducted in a dental hospital. SAMPLE The sample comprised 135 children aged between 2 and 12 years of age who were undergoing outpatient general anaesthesia for simple dental extractions. METHODS The children were randomly allocated to one of two groups: the bupivacaine group (the study group) comprised 68 children whilst the sterile water group (the control group) comprised 67. Following the extraction of their teeth, children had swabs soaked in the appropriate solution placed over the exposed teeth sockets. A five-point face scale was employed by an independent observer to evaluate the distress for each child. Evaluation of distress was made preoperatively, on recovery from the general anaesthetic, and again, 15 min following recovery from the anaesthetic. RESULTS There were no statistically significant differences between the mean distress scores for the bupivacaine and sterile water groups preoperatively, postoperatively or 15 min postoperatively. For both groups, however, there were significant increases in distress scores between the preoperative and 15 min postoperative assessment scores. CONCLUSION Extraction of teeth under general anaesthesia does cause distress in children. There is no evidence that topical bupivacaine reduces this distress when compared to sterile water.
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Affiliation(s)
- G Gazal
- Unit of Paediatric Dentistry, University Dental Hospital, Manchester, UK
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