Endodontic anesthetic (Week 9) Flashcards
What is an absolute essential to any endodontic procedure?
Profound anesthesia
Cornerstone of your model dental practice & are your greatest practice builders:
Painless injections & considerate caring manner
T/F: RCT may be possible without profound LA
False- impossible
What is the first step in atraumatic anesthetic injections:
- dry mucosa
What do you do after drying the mucosa for an injection?
Let topical anesthetic sit for 60 seconds
Vigorously shaking or gently squeezing the lip or cheek while injecting is a ____ technique thought to activate the faster _____ fibers to ____
Distraction; Alpha fibers; close the gate
How long should it take you to inject the LA?
60 Seconds
(slow and steady & talk to patient while doing this)
Palatal injections may be performed for:
any maxillary molar, premolars or anterior teeth
What injection is known to be very painful?
palatal injection
More than 1/4 carp of anesthetic for a palatal injection may result in:
tissue sloughing
You should NOT EXCEED _______ carps when doing a palatal injection
1/4
What two tactics can aid in an “almost painless: palatal injection?
- pressure
- time
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
refrigerant (endo ice)
When using a refrigerant prior to a palatal injection, you should direct the needle tip perpendicular to the:
frosted dimple (white circle)
What will your biggest challenge in achieving proper anesthesia present as?
mandibular molar with actutely inflamed pulpitis
Anesthesia here is useless due to the density of the cortical plates:
mandibular molar
What is the portion of local anesthetic that can diffuse through the neuronal membrane?
non-ionized portion (free base)
T/F: Teeth with acutely inflamed tissues are often VERY resistant to LA
True
What would the dose/directions of an anti-inflammatory prior to treatment be?
IBU 600 mg one hour prior (78% effective)
If you have a good block you should have:
“lip signs”
Only after you are POSITIVE that you have a numb and fat lip should you proceed to any:
buccal anesthesia
List some examples of supplementary injections you may give following IA block:
- intra-ligament (PDL ligament) injection
- intra-pulpal injection
- intra-osseous injection
List the duration of the more commonly used amides & give examples:
Short:
Medium:
Long:
Short: less than 60 min; Mepivacaine
Medium: 60-120 min; Lidocaine, Articaine
Long: more than 120 min: Bupivacaine
Aspirate to avoid:
intra-vascular injection
Allows articaine to penetrate cortical bone plates:
Thiophene ring
Most painful of injections:
intra-pulpal (supplementary injection)
Most commonly used LA:
2% Lidocaine with 1:100000 Epi
the maximum adult safe dosage for 2% Lidocaine=
8 capruples (272 mg)
the maximum safe adult dosage for 4% articaine=
4 capurples (272 mg)
