After topical anesthesia with 20% benzocaine gel (Precain® B; Pascal, Bellevue, WA, USA) for 1 min, IANB injections of 4% articaine and epinephrine 1:100,000 (Ubistesin™ Forte; 3 M ESPE, Seefeld, Germany) were given using the direct technique (Halstead approach) with standard dental aspirating syringes (Hu-Friedy, Leimen, Germany) and 27-G, 21 mm dental needles (Terumo®, Tokyo, Japan). To avoid undesirable systemic effects of inadvertent intravascular injection,10 (link),11 Aspiration was done prior to delivering 1.7 mL of anesthetic solution slowly over 60 s.12 (link)
Ubistesin forte
Manufactured by 3M
Sourced in United States
Ubistesin forte is a local anesthetic solution used in dental procedures. It contains the active ingredients articaine hydrochloride and epinephrine. Ubistesin forte is designed to provide effective local anesthesia during dental treatments.
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5 protocols using ubistesin forte
1
Inferior Alveolar Nerve Block Anesthesia
2
Mandibular Surgical Procedures Under Anesthesia
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All surgical procedures were performed under general anesthesia and under sterile conditions by two surgeons (DT, NN) in an operating room. Premedication included antibiotics (Buccoval, Sogeval, and Duplocilline, Intervent S.A) and pain relief medication (Dorbene Vet, Zoetis, and Buprecare, Axience). Prior to the surgery, the respective hemimandible was disinfected with 0.2% chlorhexidine solution and the region was locally anesthetized using lidocaine hydrochloride with adrenaline (Ubistesin forte, 3 M ESPE or Lidocaine adrenaline, Aguettant). The respective surgical procedures and the applied medication were described in detail in a previous publication (Thoma et al., 2017).
3
Piezoelectric Surgical Procedure for Tooth Extraction
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The surgical procedure was performed according to Dibart et al. [7 (link)] under local anesthesia with 4% articaine (Ubistesin forte; 3M ESPE, St. Paul, MN, USA). One hour before surgery, 1 g of amoxicillin (Ospamox; Sandoz, Holzkirchen, Austria) and 200 mg of ibuprofen (Ibuprofen Hasco; Hasco-Lek, Wrocław, Poland) were administered. After performing sulcular and vertical incisions in mucosa between the roots of the teeth, the mucoperiosteal flap was elevated as a tunnel, and then linear cuts were made through the buccal cortical plate using the OT7S-3 ultrasound tips of the piezosurgery device (Mectron, Carasco, Italy). Vertical cuts extended from the apical region of the roots to 2–3 mm from the crest. In the case of evident roots’ proximity, vertical cuts were abandoned. Then, the flap was sutured with resorbable monofilament 5.0 sutures (Biosyn; Medtronic, Mounds View, MN, USA). Mouth rinsing with chlorhexidine (Eludri; Pierre Fabre Sante, Paris, France) twice per day was prescribed as well as gentle tooth brushing in the surgical area for 2 weeks. The sutures were removed 14 days post-op (if necessary).
4
Anesthetic Agents Comparison in Dentistry
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The commercial anesthetic drugs used in this study were articaine-based agents: Ubistesin (522721, 3 M ESPE), Ubistesin forte (512987, 3 M ESPE), Septanest (09091451103, Septodont) and mepivacaine-based agent: Scandonest (09091173002, Septodont) and Lidocaine based agent: Xylocaine (Batch 4180, Dentsply).
5
Sinus Lift Procedure with Membrane Perforation Sealing
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The surgical phase began with local anesthesia by local infiltration, infraorbital foramen block and posterior superior alveolar nerve block using articaine hydrochloride 1:100,000 (Ubistesin Forte, 3 M ESPE, Minneapolis, MN, USA).
Following elevation of a full thickness flap, access to the sinus cavity was performed, creating an osteotomy window through the lateral wall using an ultrasound bone surgery device (Piezosurgery by Mectron s.p.a, Carasco, Italy—between 2011 and 2014, Piezomed by W&H, Bürmoos, Austria—between 2014 and 2017). Once the bony window was cut, the complete delineation of the fragment from the adjacent bony tissue was checked. The mobility of the bone fragment indicates, at this stage, that the bony window can be detached from the sinus membrane. From this moment on, perforations of the Schneiderian membrane may occur for multiple reasons such as: sharp edges of the bone window, inappropriate pressure applied with the microsaw insert, deliberate incision for mucocele removal or iatrogenic injury.
One of two sealing techniques was used to seal perforated membranes in the present study:
Following elevation of a full thickness flap, access to the sinus cavity was performed, creating an osteotomy window through the lateral wall using an ultrasound bone surgery device (Piezosurgery by Mectron s.p.a, Carasco, Italy—between 2011 and 2014, Piezomed by W&H, Bürmoos, Austria—between 2014 and 2017). Once the bony window was cut, the complete delineation of the fragment from the adjacent bony tissue was checked. The mobility of the bone fragment indicates, at this stage, that the bony window can be detached from the sinus membrane. From this moment on, perforations of the Schneiderian membrane may occur for multiple reasons such as: sharp edges of the bone window, inappropriate pressure applied with the microsaw insert, deliberate incision for mucocele removal or iatrogenic injury.
One of two sealing techniques was used to seal perforated membranes in the present study:
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