advanced techniques

Question 1

what advanced techniques are available?

Answer 1

palatal anaesthesia
intraligamental
intraosseous
jet techniques
IAN block alternative

Question 2

describe painless palatal anaesthesia

Answer 2

modified technique
-press on palate
distraction technique
-wiggle toes, breathing

Question 3

describe intraligamentary

Answer 3

into PDL
force needed to enter
twist bevel to fit directly into pdl
when standard LA not worked

Question 4

what does efficacy of ligamental anaesthesia depend on?

Answer 4

procedure
tooth
-canines, lower 3rd molars, lower laterals poor
resistance to injection
anaesthetic solution-adrenaline

Question 5

describe intraosseous injection

Answer 5

into bone
hollow tube attached to slow speed handpiece
create channel for needle to inject
cancellous bone
works instantly

Question 6

what are the advantages of topical jet injectors?

Answer 6

bleeding diatheses, where deep injections contraindicated
sole means acieving LA
prior to conventional

Question 7

what are the disadvantages of topical jet injectors?

Answer 7

expensive
soft tissue damage possible
frightening sight & sound
bad taste

Question 8

what are the alternative IAN blocks?

Answer 8

cow gates

akinosi

Question 9

describe cow gates

Answer 9

open mouth wide
px lying flat
neck of condylar process
aim high

Question 10

describe akinosi

Answer 10

if trismus etc. cant open mouth for normal block
closed mouth technique
inferior alveolar & all other branches of mandibular CNV
pull cheek open
insert horizontally high up
above gingival margin of uppers
between ramus of mandible and maxilla