Advanced Techniques In LA

Question 1

Name and describe the method used to reduce the pain of a palatal injection

Answer 1

1. Chasing anaesthesia
•give buccal infiltration
- allow to work
• inject into interdental papilla
• slowly advance needle while injecting until palatal tissues blanch
• inject into blanched area

Question 2

What factors effect the efficacy of periodontal ligament anaesthesia?

Answer 2

1. Procedure
2. Tooth
3. Resistance to injection
4. Anaesthetic solution
5. needle gauge

Question 3

What makes intraligamentary anaesthesia difficult?

Answer 3

A large amount of force is needed to inject fluid into the ligament
- often time if the bevel is placed incorrectly the solution will flow into the mouth

Question 4

What tooth has the lowest success rate when it comes to intraligamentary injection

Answer 4

Canines (46%)

Question 5

What tooth has the least pulpal anaesthesia?

Answer 5

Lower laterals

Question 6

What substance increases the success rate of local anaesthetic?

Answer 6

1:80,000 adrenaline

Question 7

What is a stab in any perforator used for?

Answer 7

Drilling a small channel into the mucosa and cancellous bone to allow an intraosseus injection (drill through bone)

Question 8

What are advantages and disadvantages of topical jet injectors?

Answer 8

1. Advantages
   - bleeding diatheses, where deep injections contraindicated
   - sole means achieving LA
   - prior to conventional techniques
2. Disadvantages
   - expensive
   - could cause soft tissue damage if careless
   - frightening sight and sound
   - taste of solution

Question 9

Name two alternative IAN block techniques

Answer 9

1. Gow gates technique

2. Akinosi technique

Question 10

Describe the akinosi technique

Answer 10

1. Needle is held horizontally at the height of the mucogingival junction above the maxillary 3rd molar

• needle is then inserted until the base of the syringe is around the 7/8 region
• injecting LA here will anaesthetise all the branches of the mandibular division of the trigeminal nerve

Question 11

What are advantages of the akinosi technique?

Answer 11

1. Can be done while the patients mouth is closed (ideal for patients with trismus)

Question 12

Describe the gow gates technique

Answer 12

1. Open mouth technique
   - patient lying flat
   - aim for neck of condylar process
   - this will anaesthetise all branches of the mandibular division

Question 13

What is the wand?

Answer 13

A machine used to inject local anaesthetic at a constant and efficient pressure in order to achieve anaesthesia with minimal pain

Question 14

What pressure does the wand inject at?

Answer 14

265 psi (ideal pressure)