LA - Supplementary Techniques

Question 1

intraligamentary anaesthesia: technique?

Answer 1

• high pressure
• low volume
• short needle

Question 2

intraligamentary anaesthesia: needle placed between what?

likely mode of action?

Answer 2

• tooth and crestal bone
• spread of solution out of PDL to cancellous bone
• intra-osseous

Question 3

why is it unlikely for LA to spread down PDL to apex?

Answer 3

it has to counteract the flow of GCF, which is difficult

Question 4

intraligamentary anaesthesia:

• efficacy requires?
• is ILA a good diagnostic tool? why?

Answer 4

• requires vasoconstrictor

- no. the anaesthesia spreads to adjacent teeth, making it difficult to use for diagnosis

Question 5

advantages of intraligamentary anaesthesia?

Answer 5

• low dose (0.2ml per root)
• rapid onset
• little soft tissue anaesthesia
• provides alternative to IAB for those with bleeding problems

Question 6

disadvantages of intraligamentary anaesthesia?

Answer 6

• possible pdl damage
• post-injection pain
• not always effective
• short/variable duration
• tooth extrusion
• significant bacteraemia: not suitable if endocarditis risk
• technique sensitive

Question 7

intraligamentary anaesthesia: 3 steps?

Answer 7

1. infiltration
2. perforation
3. intraosseous anaesthesia

Question 8

intra-papillary anaesthesia: useful for? what has to be carried out beforehand? what to look out for to see if the LA is working?

Answer 8

• useful for children, as it provides comfortable palatal anaesthesia.
• requires buccal/labial infiltration beforehand
• palatal blanching

Question 9

intrapapillary anaesthesia: advantages?

Answer 9

• computer controlled flow rate
• pen grip
• claims faster onset of anaesthesia
• claims to bypass deviation of needle
• useful for anxious patients
• useful for children

Question 10

intrapapillary anaesthesia: disadvantages?

Answer 10

• high cost of equipment: capital cost vs ongoing
• takes time to get used to, requires practice
• takes a long time to deliver LA: infiltration might wear off by the time intrapapillary injection is ready
• requires special cartridges: 1.8ml. compatibility issues

Question 11

intra-periodontal pocket - oraqix:
mixture of?
how does it work?
can be useful for?

Answer 11

• lidocaine 2.5% & prilocaine 2.5%
• no needles, LA not injected, instead viscous liquid is put into periodontal pocket, and then it fprms a gel
• useful for root surface debridement