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Oral Surgery > Chapter 12: local anaesthetics in dentistry classification, materials > Flashcards

Chapter 12: local anaesthetics in dentistry classification, materials Flashcards

1
Q

What is regional anaesthetics?

A

The area anaesthetised belongs to the main nerve or an important branch

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2
Q

When we anaesthetise we must take into account the nerves that innervate the _____ _____ around the tooth and not just the nerve innervating the tooth itself

A

Soft tissues

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3
Q

LA: drug action is on _____ (around) level

A

Periferic

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4
Q

Advantages of LA

A
  • Gold standard when tooth insensitivity is needed
  • Conscious patient
  • Exceptional mortality
  • It does not need special training for practitioners
  • Easy technique
  • Low failure rate
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5
Q

Disadvantages of LA

A
  • Allergies to any local anaesthetics component
  • In patients with cerebral palsy, there is no collaboration
  • Insufficient in more complex or aggressive techniques
  • Not indicated in an acute infectious process.
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6
Q

LA techniques

A
  1. Topical
  2. Local infiltration
  3. Field block
  4. Nerve block
  5. Intravascular
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7
Q

What does topic LA act on?

A

Sensory nerve endings

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8
Q

What does local infiltration act on?

A

Small terminal nerve endings in the area of dental treatment (they get flooded with LA solution)

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9
Q

How does the field block work?

A

LA solution is deposited near the larger terminal nerve branches so the
the anaesthetised area will be circumscribed

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10
Q

How does the nerve block work?

A

LA is deposited close to the main nerve trunk, usually at a distance from the site of
operative intervention

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11
Q

Risks of intravascular technique

A
  • Cardiac risk
  • Large ischemia
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12
Q

What do we use when we want to restore 2-3 teeth?

A

Field block

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13
Q

What do we use when we want to control pain in a quadrant?

A

Regional block

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14
Q

What do we do if there is a 3rd molar extraction and a cut that exposes the pulp?

A

We use intrapulpal anaesthesia

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15
Q

Is intrapulpal harmful?

A

Yes it is, but it is also very useful

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16
Q

Is intraosseous anaesthesia harmful? If yes why?

A

Intraosseous is harmful because the LA is injected into a small space that cannot be stretched and the pressure will be great

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17
Q

What is the least painful technique?

A

Infiltration

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18
Q

Injection of LA in the mucosa:

A
  • Low toxicity
  • Low concentration
  • Better ointment than spray
  • Bests results in dry mucosa
  • Unpleasant taste
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19
Q

Injection of LA in the submucosa:

A
  • Superficial submucosa: in superficial lesions, forms papule
  • Supraperiosteal: infiltration, goes through periosteum, external cortical
    a. = Local infiltration, paraperiosteal injection.
    b. Nerves anaesthetised: large terminal branches of the dental plexus
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20
Q

Injection of LA in subperiosteal:

A
  • Between cortical and periosteum
  • Very painful
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21
Q

Injection of LA intraligamentary:

A
  • PDL
  • Recommended as an adjunct to other techniques or for limited treatment
    protocols
  • Maintain the needle’s 45-degree orientation
  • Insert the needle into the sulcus, inside the attachment
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22
Q

Injection of LA intraosseus:

A
  • LA is deposited in the medular (medular cavity)
  • Recommended for single teeth when other techniques have failed
  • Intraseptal
  • Hard because our needles are thin and our bones are hard, might need thicker needles
  • Used as a last resort
23
Q

Injection of LA intrapulpal:

A
  • LA is specifically deposited in the pulp
  • Tooth must be anaesthetised before
  • Complementary technique
24
Q

LA armentarium:

A
  • Syringe
  • Needles
  • Cartridges
25
Q

ADA criteria for LA syringes:

A
  • They must be durable
  • Capable of accepting a wide variety of cartridges and needles
  • Inexpensive, self-contained, easy to use with 1 hand
  • Provide effective aspiration, and blood may be easily observed in the cartridge
26
Q

Types of syringes

A
  1. Non-disposable syringes
  2. Disposable syringes
  3. Safety syringes
  4. Computer-controlled LA delivery systems
27
Q

Not all syringes are necessary aspirating. True or False

A

False, all of them are aspirating syringes, because they represent the standard of care

28
Q

Who created the first dental syringe? And when?

A

Charles Pravaz patented the 1st dental syringe in 1853

29
Q

Safety syringes benefits

A
  • Minimise the risk of incidental needle-stick injury
  • Sheath that locks over the needle when it is removed from the patient’s area after LA is administered
30
Q

Non-disposable syringes characteristics

A
  • Breech-loading
  • Metallic or Plastic
  • Cartridge-type
  • Aspirating/Self-aspirating
31
Q

What happens when negative pressure is exerted on the thumb ring?

A

Blood enters in the cartridge

32
Q

Aspirating is done with the sharp tip. True or False

A

True

33
Q

What does positive pressure do when it is exerted?

A

It forced the LA into the patient’s tissues

34
Q

Are disposable syringes available in a variety of sizes?

A

Yes they are, with an assortment of needles gauges as well

35
Q

What syringe is most often used for intramuscular or intravenous drug administration?

A

The disposable syringe

36
Q

When was the first computer-controlled LA delivery systems created?

A

In 1997, the first CCLAD was introduced into dentistry

37
Q

What is the purpose of computer-controlled LA delivery systems?

A

CCLAD was designed to improve on precision and ergonomics of the dental syringe

38
Q

Parts of the syringe

A
  • Thumb ring
  • Finger grip
  • Barrel
  • Harpoon/Piston (there are different types of harpoons)
  • Tip / Needle adaptor
39
Q

What is the needle of a syringe?

A

A single piece of tubular metal around which is placed a plastic or metal syringe adaptor and the needle hub

40
Q

Components of a needle

A
  • Bevel
  • Shaft
  • Hub
  • Syringe adaptor
  • Cartridge penetration end
41
Q

What does the gauge refer to?

A

It refers to the diameter of the lumen of the needle

42
Q

Needle sizes (long and short)

A

Long: 31-40 mm
Short: 16-30 mm

43
Q

What size of long needle do we use in dentistry?

A

35 mm

44
Q

What size of short needle do we use in dentistry?

A

23-25 cm

45
Q

What are cartridges known as?

A

Carpule

46
Q

How much LA solution do cartridges contain?

A

1.8 mL

47
Q

When were cartridges introduced into dentistry? And by who?

A

Cook-Waite in 1920

48
Q

Components of cartridges

A
  • Cylindrical glass tube
  • Stopper (plunger, bung)
  • Aluminium cap
  • Diaphragm
49
Q

Function of LA drug

A

Blockade of nerve conduction

50
Q

Function of sodium chloride

A
  • Isotonicity of the solution
  • Antioxidant
51
Q

Function of sterile water

A

Volume

52
Q

Function of vaspressor

A

Higher depth and duration of anaesthesia

53
Q

Function of methylparaben

A

Bacteriostatic agent

54
Q

What LA can be topical?

A
  1. Lidocaine: liquid and ointment
    a. Xylonor solution 5%
    b. Xylonor spray 15%
    c. Xylonor gel 20%
  2. Tetracaine: peryl spray 3.5%
  3. Benzocaine: hurricane gel 20%

Oral Surgery (5 decks)

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