Endodontic anesthetic (Week 9)

Question 1

What is an absolute essential to any endodontic procedure?

Answer 1

Profound anesthesia

Question 2

Cornerstone of your model dental practice & are your greatest practice builders:

Answer 2

Painless injections & considerate caring manner

Question 3

T/F: RCT may be possible without profound LA

Answer 3

False- impossible

Question 4

What is the first step in atraumatic anesthetic injections:

Answer 4

1. dry mucosa

Question 5

What do you do after drying the mucosa for an injection?

Answer 5

Let topical anesthetic sit for 60 seconds

Question 6

Vigorously shaking or gently squeezing the lip or cheek while injecting is a ____ technique thought to activate the faster _____ fibers to ____

Answer 6

Distraction; Alpha fibers; close the gate

Question 7

How long should it take you to inject the LA?

Answer 7

60 Seconds

(slow and steady & talk to patient while doing this)

Question 8

Palatal injections may be performed for:

Answer 8

any maxillary molar, premolars or anterior teeth

Question 9

What injection is known to be very painful?

Answer 9

palatal injection

Question 10

More than 1/4 carp of anesthetic for a palatal injection may result in:

Answer 10

tissue sloughing

Question 11

You should NOT EXCEED _______ carps when doing a palatal injection

Answer 11

1/4

Question 12

What two tactics can aid in an “almost painless: palatal injection?

Answer 12

1. pressure
2. time

Question 13

Use of a _____ as pre-injection anesthetic was more effective when compared with a topical gel in reducing pain by patients receiving a palatal injection

Answer 13

refrigerant (endo ice)

Question 14

When using a refrigerant prior to a palatal injection, you should direct the needle tip perpendicular to the:

Answer 14

frosted dimple (white circle)

Question 15

What will your biggest challenge in achieving proper anesthesia present as?

Answer 15

mandibular molar with actutely inflamed pulpitis

Question 16

Anesthesia here is useless due to the density of the cortical plates:

Answer 16

mandibular molar

Question 17

What is the portion of local anesthetic that can diffuse through the neuronal membrane?

Answer 17

non-ionized portion (free base)

Question 18

T/F: Teeth with acutely inflamed tissues are often VERY resistant to LA

Answer 18

True

Question 19

What would the dose/directions of an anti-inflammatory prior to treatment be?

Answer 19

IBU 600 mg one hour prior (78% effective)

Question 20

If you have a good block you should have:

Answer 20

“lip signs”

Question 21

Only after you are POSITIVE that you have a numb and fat lip should you proceed to any:

Answer 21

buccal anesthesia

Question 22

List some examples of supplementary injections you may give following IA block:

Answer 22

1. intra-ligament (PDL ligament) injection
2. intra-pulpal injection
3. intra-osseous injection

Question 23

List the duration of the more commonly used amides & give examples:

Short:
Medium:
Long:

Answer 23

Short: less than 60 min; Mepivacaine

Medium: 60-120 min; Lidocaine, Articaine

Long: more than 120 min: Bupivacaine

Question 24

Aspirate to avoid:

Answer 24

intra-vascular injection

Question 25

Allows articaine to penetrate cortical bone plates:

Answer 25

Thiophene ring

Question 26

Most painful of injections:

Answer 26

intra-pulpal (supplementary injection)

Question 27

Most commonly used LA:

Answer 27

2% Lidocaine with 1:100000 Epi

Question 28

the maximum adult safe dosage for 2% Lidocaine=

Answer 28

8 capruples (272 mg)

Question 29

the maximum safe adult dosage for 4% articaine=

Answer 29

4 capurples (272 mg)