Local Anesthesia

Question 1

Purpose of anesthesia

Answer 1

Block transmissions so brain is unaware that it hurts

• body unsure what’s going on
• temporary

Question 2

Infiltration

Answer 2

Anesthetic placed close to an individual tooth apex

• one tooth
• maxillary teeth only, mand can’t infiltrate

Question 3

Regional block

Answer 3

Higher up in nerve organization (PSA)

*couple of teeth

Question 4

Nerve block

Answer 4

Near a nerve trunk (V3)

*big area

Question 5

Anes- Maxilla

ASA

Answer 5

ASA- anterior teeth, facial soft tissues and preiodontium

safe easy injections, not many complications. NO palatal tissues

Question 6

Anes- maxilla

MSA

Answer 6

MSA- premolars and mesial buccal tooth of the 1st molar (only in about 27-28% of people)
*act like all people have MSA

*safe easy injection, NO palatal tissue

Question 7

Anes- Maxilla

PSA

Answer 7

Molars except mesial buccal root of 1st molar

CAUTION: pterygoid plexus of veins can be pierced readily with this injection and can cause a Hematoma

Question 8

Anes- Palatal

NP

GP

Answer 8

NP- Palatal tissue of the ore maxilla #6-11

GP(2 nerves)- remaining palatal tissue bilaterally

• # 1-5, # 12-16
• inj site in GP for amen- usually lingual to 2nd molar

Question 9

Anes- Mandible

Incisive-

Long Buccal-

Answer 9

Premolars and anteriors with associated periodontium and Buccal gingiva.

• wont get lingual tissue, will get teeth and incisive nerve and mental nerve.
• could get hematoma

Branch of V3 sensory buccal gingiva associated with mandibular molars
*anterior portion of ramus for injection site

Question 10

Anes- Mandible

IA/L-

Innervates-

Answer 10

Entire mand. quad except for the buccal nerve distribution.

• anesthetic should be placed superior to mand foramen, in the mand sulcus
• neurovascular bundle

Mandibular molars

Question 11

More anesthesia variations:

5

Answer 11

1 Mylohyoid nerve
2 Palatal
3Cross over innervation
4 Intraosseous
5 Parotid gland- 7 affected. Parotid space-PSA anesthetic gets in space and causes paralysis

Question 12

Anes- Supplemental (extra inj)

PDL-

Interseptal-

Answer 12

PDL- anesthetic will penetrate bone via the ligament to create anesthesia

Interseptal- not for anesthesia hemorrhage control
*in papillae(close to area)

Question 13

Anesthesia

V2-

V3-

Answer 13

V2- 2 approaches

• high PSA
• greater palatal foramen

V3- Gow- gates approach
*anesthesia at neck of condyle

HIGH RISK INJ