managing local anesthesia for endo Flashcards

1
Q

articaine

A

1) amide and ester properties

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

amides

A

1) metabolized hepatic system

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

ester

A

1) metabolized by plasma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

intermediate duration of pulpal anesthesia

A

1) about 60 minutes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

which anesthetics are safe to use for pregnancy

A

1) lidocaine is safe
2) articaine, bupivacaine, mepivacaine category C

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

maxillary teeth

A

1) 1-2 carps of 4% articaine with 1:100k epi
2) buccal infiltration and 1/4 carp on the lingual aspect for rubber dam clamp

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

success of lidocaine in maxillary

A

1) works well

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

does increasing cartridge of anesthetics help in maxillary

A

1) not really, just use 1 carp

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

articaine sucess rate

A

1) higher than lidocaine for incisors
2)about the same for molars

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

buccal plus palatal

A

1) usually better for hot tooth
2) gets more numb

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

PSA

A

1) might cause a hematoma
2) usually infiltration is better

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

augmentation

A

1) supplement at the 30 minute mark
2) do not wait until the whole time

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

standard protocol for mandibular teeth

A

1) anteriors
- infiltration 1-2 carps of articaine
2) molars and premolars
- IA block with 2% lidocaine
- give a supplemental infiltration of articaine 1/2 buccal, 1/2 lingual when they start to feel tingly

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

how to check for anesthesia

A

1) endo ice for RCT because you are going all the way to the nerve
2) leave it on for several seconds

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

why is failure of a block higher for anteriors

A

1) central core theory
2) axons in the outer area innervate molars and premolar
3) but the inner core area innervates the anteriors

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

anesthesia success in symptomatic irreversible pulpitis

A

1) not a hot tooth, IANB is 75-90% success
2) with a hot tooth, IANB success is 15-57%
3) people with significant pre op pain 16%

17
Q

septocaine vs lidocaine for blocks

A

1) success is the same
2) suggestion to not use articaine
- 5x more risk for nerve injuries
- risk for paresthesia…is overall still really really low
- so maybe the result is overblown

18
Q

medications for pre-op

A

1) ibuprofen

19
Q

nitrous

A

1) success is 50%

20
Q

patient related factors

A

1) hx of diabetes and pre-op pain interfere
2) pts. with red hair has MC1R
- may have more anxiety and fear

21
Q

supplemental anesthetic injections

A

1) intraosseous
- special syringe to go into cortical bone
- success is a lot higher
2) intraligamentary
- PDL injection
3) intrapulpal
- FINAL resort

22
Q

considerations for intraosseous

A

1) do not do in painful teeth with necrotic pulp
2) do not do it with cellulitis or abscess
3) or bisphosphonate issues

23
Q

buccal infiltration after block

A

1) articaine > lidocaine for supplementals

24
Q

PDL injection

A

1) use intraligamentary syringe
- grab that
2) the manual PDL injection may not have enough pressure
3) often may feel occlusion is high afterward
4) may be painful

25
intraosseous
1) slow speed handdrill to drill into the bone 2) then use needle to insert into the sleeve
26
intrapulpal
1) super painful 2) success is backed on presence of back pressure 3) success drops when access is large
27
gow gates vs IAN
1) no difference for a hot tooth
28
can always do a pulpotomy only
1) 96% pain relief 2) do not need to start debridement if not time
29