Articaine and Paresthesia in Dental Anesthesia: Neurotoxicity or Procedural Trauma?

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by Dr. M. Toma, Dr. M. Berghahn, S. Loth, B. Verrengia, Dr. L. Visani and F. Velotti , Articaine and Paresthesia in Dental Anesthesia: Neurotoxicity or Procedural Trauma?
Speaker: by Dr. M. Toma, Dr. M. Berghahn, S. Loth, B. Verrengia, Dr. L. Visani and F. Velotti
Category: Anesthesia
CE Credits: 1.5
Format: PDF
This course is designed to educate the dental health professional concerning the occurrence and overall incidence of reported local anesthetic-induced paresthesia. In addition, it will serve to illust...more
  • 3.3 (3 Reviews)
  • Released: 5/1/2013
  • Expiration Date: 6/1/2019
  • Review Date: 6/1/2016
CE Details
Credit Details
This electronically delivered self-instructional program is designated for 1.5 hours of CE credit by Farran Media.
AGD Code: 132.

There is no fee to view this course. There is a fee of $36 to take the exam and claim CE credits for this course.

Synopsis:
This course is designed to educate the dental health professional concerning the occurrence and overall incidence of reported local anesthetic-induced paresthesia. In addition, it will serve to illustrate the potential causes of such paresthesia and to investigate whether the use of articaine is related to a higher frequency of occurrences of these adverse events.

Description of Speaker:
Dr. Mihaela Toma, graduated physician, has been working in the field of CRO industry, gaining experience in the fields of Pharmacovigilance, Regulatory Affairs and Quality Assurance. She joined Pierrel Research in 2005. Dr. Toma is currently Drug Safety Officer and Quality Management Manager. She has a degree of specialist physician in Internal Medicine. She has also gained a Doctorate MD awarded by the Medical Faculty of the University of Zurich, Switzerland. Dr. Michael Berghahn has a degree in chemistry and also gained an MSc in Pharmaceutical Medicine. He has been working in the field of clinical research since 2004 with a focus on clinical operations and pharmacovigilance. Today Dr. Berghahn is Director of Pharmacovigilance and Medical Services at Pierrel Research Europe GmbH, Germany. Stefan Loth holds a degree in biology and gained further qualification as scientific editor. He got into the biomedical industry working for a media agency. His medical writing career started by joining Pierrel Research Europe in 2006. Mr. Loth regularly writes publications for scientific journals and develops the documents for drug development programs of Pierrel customers. He is a member of the European Medical Writers Association (EMWA). Bernardo Verrengia was educated in the U.K. and gained an Honors Degree in Chemistry at The Royal Institute of Chemistry. In 1974 he was engaged by Albright and Wilson as Research Analyst in their R&D Department and later by VG instruments as mass spectrometry applications specialist. In 1982 he moved to Italy with Pierrel as Head of Analytical Chemistry in the Pharmaceuticals R&D Department. He has been actively involved in many R&D projects on new pharmacologically active chemical entities with NDA submissions and approvals in Europe, Canada, Russia and The USA. He has held positions of Site Manager and Qualified Person for many years within the Pharmacia Group, with main experience in the development and manufacturing of loco-regional anaesthetics. Today he is the Scientific and Regulatory Officer at Pierrel SpA. For further information please contact b.verrengia@pierrelgroup.com. Dr. Luigi Visani is doctor in medicine and specialist in cardiology. For about 13 years he has served as Director of Clinical Research of the Italian Operative Unit at Boehringer Ingelheim Italy. In 1998, he took the position of Managing Director at Hyperphar Group, (now Pierrel Research Italy), a leading CRO in Italy. Member of the Board of Directors of Pierrel SpA from December 2008 until January 2011, CEO of Pierrel SpA. Currently chairman and CEO of Pierrel Research International AG and CEO of Pierrel Research Europe GmbH. Fabio Velotti was educated at the Federico II University, in Naples (Italy) and gained a master’s of science degree in engineering. In 1999 he was engaged by DSM Royal Dutch where he covered several positions, basically focused on the development, manufacturing and commercialisation of pharma biotech products. In 2011 he moved to Pierrel in order to manage Pierrel pharmaceuticals products portfolio. Today he is the CEO at Pierrel Pharma. For further information, please contact f.velotti@pierrelgroup.com.

Educational Objectives:
Upon completion of this course, participants should be able to achieve the following:
  • Form an opinion concerning whether there is sufficient data to suggest an increased incidence of neurological side effects associated with the use of articaine.
  • Attain an awareness of other potential causes of neurological effects in patients undergoing local anesthesia.
  • Consider and evaluate the overall risk of local anesthetics in general as a significant contributor to neurologic adverse events.
  • Consider additional risk factors paresthesia might be attributed to in local anesthesia, like procedural trauma and experience of dentist.
  • Understand why randomization is the design of choice for clinical trials as it provides the most reliable results when investigating the risk of paresthesia after use of anesthetics.

Disclosure:
Disclaimer: The authors declare that neither they nor any member of their families have a financial arrangement or affiliation with any corporate organization offering financial support or grant monies for this continuing dental education program nor have a financial interest in any commercial products or services discussed in this article.

CE Reviews

Overall

3.3  (3 Total Reviews)
 
Instructor spoke clearly and was easy to understand
4.7
Course material was informative, organized, and up to date
3.7
Course objectives were consistent with course as advertised
4.7
Poor analysis of the literature
mjhdds
User: mjhdds
Date: 5/10/2015
Instructor spoke clearly and was easy to understand
5
Course material was informative, organized, and up to date
2
Course objectives were consistent with course as advertised
4
The analysis of data by the authors was poor at best. They should know that closed claim analysis provides excellent data compared to the self reporting data to Canadian health officials. As they state that definitive proof of nerve damage due to toxicity of 4% local anesthesia is true but only due to the fact that direct proof would require microscopic examination of the nerve of human patients which is impossible. However, they ignored studies with rat sciatic nerves where they were directly introduced to 4% local and suffered toxic damage. Also, these same rat nerves were subjected to direct contact with a needle and resulted in no paraesthesia.
good information, but boring to read
lisabeck
User: lisabeck
Date: 6/5/2013
Instructor spoke clearly and was easy to understand
4
Course material was informative, organized, and up to date
4
Course objectives were consistent with course as advertised
5
no additional comments
Good course. Very informative
veber
User: veber
Date: 5/19/2013
Instructor spoke clearly and was easy to understand
5
Course material was informative, organized, and up to date
5
Course objectives were consistent with course as advertised
5
Good course
CE Policies
American General Dentistry (AGD), Program Approval for Continuing Education (PACE) approved, FAGD / MAGD CreditApproved PACE Program Provider
FAGD / MAGD Credit
Approval does not imply acceptance by a state or
provincial board of dentistry or AGD endorsement.
1/1/2016 to 12/31/2018
Provider ID# 304396
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Farran Media is an ADA CERP Recognized Provider.
ADA CERP is a service of the American Dental Association to assist dental professionals in identifying quality providers of continuing dental education. ADA CERP does not approve or endorse individual courses or instructors, nor does it imply acceptance of credit hours by boards of dentistry.
This activity meets the educational criteria required for verifiable Continuing Professional Development under the General Dental Council Lifelong Learning scheme and represents 1.5 hours of verifiable CPD.

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