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xD3 Endo Final > Anesthesia in Endo (Archer) > Flashcards

Anesthesia in Endo (Archer) Flashcards

1
Q

What percentage of general dentists have had an anesthesia failure in the previous 5 days of practice?

A

90%

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2
Q

What percent of the US population experienced a toothache in the last 6 months?

A

12%

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3
Q

Why correlate anesthesia failure with the percentage of population having toothaches?

A

It illustrates that toothaches and anesthesia failure are both common

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4
Q

What are 3 pulpal diagnoses to consider when trying to get anesthesia?

A
  1. Healthy Vital Pulp
  2. Vital Pulp with Irreversible Pulpitis
  3. Necrotic pulp
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5
Q

What is the primary dental injection for the mandible?

A

IAN block

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6
Q

What is the primary dental injection for the maxilla?

A

Infiltration

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7
Q

What are pulpal anesthesia onset times for IAN block?

A

15 minutes

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8
Q

What is the pulpal anesthesia onset time for maxillary infiltration?

A

5 minutes

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9
Q

Does asking the patient if their lip is numb or poking their gingival give us an indication of their level of pulpal anesthesia?

A

No

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10
Q

Why is asking if lip is numb or poking with an instrument useful?

A

Lets us know if we were in the correct area to do our numbing.

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11
Q

What are 2 ways to determine pulpal anesthesia?

A
  1. EPT

2. Cold

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12
Q

What are the diagnostic test (EPT and COLD) results for a tooth with a healthy pulp after anesthesia?

A
  1. Negative cold response

2. 80/80 EPT

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13
Q

Which arch is harder to anesthetize?

A

Mandibular

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14
Q

Of the mandibular teeth, which ones are more difficult to anesthetize?

A

Anteriors

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15
Q

Why is an IAN first molar success rate (51-75%) higher than IAN central incisor success rate (10-50%)?

A

Central core theory. Posterior teeth served by nerves on the outer mantle. More anterior teeth have innervations from the interior core bundle.

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16
Q

Does the Akinosi or Gow Gates improve IAN success rates?

A

No

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17
Q

Does the volume of the agent (1.8ml vs 3.6ml) have an effect on IAN success?

A

No

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18
Q

What is the status of pulps with irreversible pulpitis?

A

An inflamed pulp with a reduced excitability threshold due to inflammatory mediators.

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19
Q

Why does irreversible pulpits have a lowered response to local anesthetic?

A

Sodium channels have been altered

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20
Q

What is the success rate of IAN block for teeth with irreversible pulpits?

A

15 to 25%

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21
Q

What indicates a lack of anesthesia on a tooth with IP that has been anesthetized?

A
  1. Positive cold response

2. Less than 80/80 EPT

22
Q

Does a negative cold response or 80/80 EPT always indicate profound anesthesia on a tooth with irreversible pulpits?

A

Not always

23
Q

What can be done to aide in getting profound anesthesia on a tooth with irreversible pulpits?

A

Supplemental injections

24
Q

What is the IAN block success rate on mandibular molars?

A

51%

25
Q

What is the IAN block success rate on mandibular molars supplemented with local infiltration with 4% articaine with 1:100k eli?

A

88%

26
Q

What is the IAN block success rate on mandibular molars with irreversible pulpits supplemented with local infiltration with 4% aticaine with 1:100K epi?

A

58%

27
Q

Does IAN supplementation with local infiltration of 4% articaine give predictable results?

A

No

28
Q

What is the IAN block success rate on mandibular molars supplemented with local infiltration of 2% Lidocaine with 1:100K eli?

A

71%

29
Q

Nuzum found what anesthesia and technique achieved 98% anesthesia success in the healthy pulps of Mandibular anteriors?

A

Labial and lingual infiltrations of mandibular anteriors with 4% articaine with 1:100K epi

30
Q

What are the only teeth anesthetized by incisive nerve blocks?

A

Premolars, not incisors

31
Q

What is the success rate of intraosseous anesthesia with 2% lidocaine with 1:100K eli?

A

91%

32
Q

What is the success rate of intraossesous anesthesia

A

80% (98% with 3.6 mL)

33
Q

What is the success rate of intraosseous anesthesia with 4% Articaine with 1:100K eli?

A

86%

34
Q

What are side effects of intraosseous injections?

A

Large uptake causes systemic effect of increased heart rate that is transient (avoid by using 3% Mepivicaine plain)

35
Q

Where is the location for a Stabident intraosseous injection site?

A

Attached gingiva so can locate hole

36
Q

What are ideal areas to do intraosseous injections?

A

Distal to the tooth working on

37
Q

What indication is there that you have perforated the cortical plate and are int he trabecular bone where you desire to give the intraosseous injection?

A

Feel al little back pressure

38
Q

What is the major difference of the X-tip system and the Stabident?

A

X-tip can be done in unattached gingiva because it leaves a guide into the bone giving a repeatable injection port

39
Q

What is the best option for achieving profound anesthesia on a tooth with irreversible pulpits?

A

Supplemental intraosseous injection

40
Q

What are 2 ways to increase maxillary anesthesia efficacy?

A
  1. Use an agent with a vasoconstrictor

2. Use 2 carpules (3.6mg) 2% Lido 1:100K epi

41
Q

The use of 2 carpules as well as a vasoconstrictor do what to aide anesthesia: increase amount of anesthesia or increase duration of anesthesia?

A

Duration

42
Q

Of the maxillary teeth, which are the only ones that respond better to articaine than lidocaine?

A

Lateral incisors only

43
Q

Does a V2 block work for the maxillary premolars and maxillary anteriors?

A

No only for molars

44
Q

Does the infraorbital block work for anesthesia of the maxillary anteriors?

A

No. Only for molars.

45
Q

Does the infraorbital block work for anesthesia of the maxillary incisors?

A

No

46
Q

Will a PSA work for a 1st molar?

A

No, only for 2nd molar

47
Q

What percentage of maxillary teeth require supplemental intraosseous anesthesia?

A

12%

48
Q

What anesthetic technique works best for necrotic teeth?

A

Block anesthesia if possible

49
Q

Should you inject into a swelling or around it?

A

Around it

50
Q

Is supplemental intraosseous injection indicated for a necrotic tooth?

A

No

xD3 Endo Final (8 decks)

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