Supplemental LA techniques Flashcards
what is Intraligamentary/periodontal ligament injection?
inject LA directly into PDL space
Low volume dose under high pressure with short needle -> have to use kit
in intraligamentary/periodontal ligament injection why does the cartridge have to be enclosed?
in case it breaks under pressure it doesn’t go in patients mouth
what is the technique for intraligamentary/periodontal ligament injection?
Insert till wedged between tooth and bone
inject slowly 0.2ml/root over 20s
Leave needle in till anaesthetic disperses then take out
Inject distally and mesially
what is the mode of action for intraligamentary/periodontal ligament injection?
exits PDL through pores in lamina dura and diffuse down in spaces of bone to apex
does intraligamentary/periodontal ligament injection need vasoconstrictor?
yes
what are the advantages of intraligamentary/periodontal ligament injection?
low dose of anaesthetic, rapid onset, little soft tissue anaesthesia, alternative to IANB as no bleeding problems
what are the disadvantages of intraligamentary/periodontal ligament injection?
PDL damage risk, post injection pain, not always effective, short/variable duration, tooth extrusion (tooth pushed up due to fluid), risk of bacteraemia (not suitable if endocarditis risk), technique sensitive, lack of soft tissue anaesthesia (patient can’t feel numbness so think its not worked)
explain the technique for direct injection into bone
Anaesthetise the surface mucosa then drill hole in bone and inject into the hole
what are the disadvantages of direct injection into bone?
perforation into tooth
difficulty finding the hole to inject in
what is intra-papillary anaesthesia useful for?
children as makes palatal injections more comfortable
what is the technique for intra-papillary injection?
Buccal/labial infiltration
Inter dental papilla injection
Slowly advance from buccal to palatal
Inject as needle advances
Pass needle through until see blanching of palatal side (goes white/paler)
what is Akinosi injection
high block alternative technique for IANB
what is the technique for Akinosi injection?
Patient has mouth closed
Needle enter above upper 7s
Needle passes back parallel to the upper arch and inside medial to the mandible
Stop when 1cm out of patient, 2.5cm in
when is akinosi injection useful?
Can be useful if IANB fails
what is intraperiodontal pocket anaesthesia?
intra-pocket topical anaesthetic - blunt tube -> no needle
what is this technique?
intraligamentary/periodontal ligament injection
what is this technique?
direct injection into bone
what is this technique?
intra-papillary injection
what is this technique?
akinosi injection
what is this technique?
intra-periodontal pocket anaesthesia
