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ENDO II > mandibular anesthesia > Flashcards

mandibular anesthesia Flashcards

1
Q

does lip numbness indicate pulpal anesthesia

A

not really

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2
Q

do soft tissue sticks indicate pulpal anesthesia

A

no

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3
Q

electric pulp test readings less than ____ resulted in pain during restorative procedures

A

less than 80

anything higher than an 80 indicated pulpal anesthesia

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4
Q

rank from most successful to least successful pulpal anesthesia via IAN block with 1 carp lido: lateral incisor, first premolar, first molar

A 
first premolar (60%)
first molar (55%)
lateral incisor (30%)
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5
Q

is anesthetic failure in incisors and molars the same?

A

no

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6
Q

what tooth is most likely to have anesthetic failure after IAN block?

A 
lateral incisor (32%)
first molar (17%)
first premolar (11%)
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7
Q

slow onset of anesthesia in mandibular teeth occurs ______% of the time

A

19-27%

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8
Q

what percentage of mandibular teeth won’t have anesthetic onset until 30-50 mins later

A

8%

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9
Q

t/f: duration of pulpal anesthesia in mandibular teeth is very good for patients who initially achieve anesthesia

A

T

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10
Q

t/f: it doesn’t matter if you have had previous difficulty with getting numb

A

false

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11
Q

will plain mepivicaine/prilocaine work for an IAN block?

A

yep

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12
Q

t/f: 3% mepivicaine with NO epi is as effective as regular lido with 1:100k epi in IAN block

A

true

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13
Q

bupivicaine w/ 1:200k epi (marcaine) has a slower or faster onset than lidocaine w/ 1:100k epi

A

SLOWER

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14
Q

how long can you expect pulpal anesthesia with lidocaine

A

2.5 hrs

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15
Q

how long can you expect pulpal anesthesia with bupivacaine (marcaine)

A

4 hrs

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16
Q

which lasts longer: lidocaine or marcaine

A

marcaine

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17
Q

is articaine better for IAN than lidocaine

A

no

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18
Q

success rate for lidocaine vs articaine in irreversible pulpits

A

basically the same, 24%

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19
Q

when is articaine more effective than lidocaine

A

INFILTRATIONS, 3.55x more likely to work

no difference for IAN blocks

20
Q

paresthesia with articaine vs lidocaine

A

5x more likely with articaine, but incidence is less than 1 in 785,000

21
Q

are gow-gates/akinosi superior to the standard IAN block?

A

no

22
Q

does increasing the volume of lidocaine injected increase indidence of pulpal anesthesia with IAN block

A

no

23
Q

will giving another IAN block help patients during treatment

A

not really

24
Q

does using a higher concentration of epi help with IAN efficacy

A

no

25
Q

does the mylohyoid nerve contribute to pulpal anesthesia

A

not significantly

26
Q

does lack of an accurate IAN injection cause failure

A

no? huh

27
Q

does accurate location of IAN bundle with ultrasound improve success

A

no

28
Q

does incorrect needle bevel orientation cause IAN failure

A

no

29
Q

does cross innervation cause the majority of failure in incisor teeth

A

no

30
Q

why dont patients get pulpal anesthesia with IAN injection?

A

anesthetic solution may not diffuse into the nerve trunk to reach all the nerve bundles

31
Q

how to evaluate pulpal anesthesia before starting treatment

A

ice test

32
Q

if a patient responds with ice response after numbing them up…

A

consider using supplemental injections

33
Q

t/f: if a patient is experiencing SIP, after you numb them up and get a negative ice test you are good to go

A

no, cold testing may not always indicate anesthesia for SIP

34
Q

which is more effective: a slow 60 sec IAN injection or a rapid 15 sec injection

A

slow

35
Q

does adding on a PDL injection increase success of IAN blocks with pulpal anesthesia

A

yes

36
Q

is a PDL injections as successful as intaosseous

A

no

37
Q

extractions: success of mandibular molar extractions with IAN alone

A

74%

38
Q

extractions: success of mandibular molar extractions with IAN and intraosseous

A

95%

39
Q

is articaine statistically superior to lidocaine in buccal infiltrations of mandibular first molars

A

yes (81% vs 65%)

40
Q

you can get a good success rate with just labial and/or lingual infiltrations of articaine in mandibular anterior teeth but….

A

they aren’t numb for an hour

41
Q

what is an option for mandibular anterior teeth

A

IAN plus labial infiltration of articaine

42
Q

does articaine infiltration work on a tooth with SIP

A

not that great (24-58% success), intraosseous is better

43
Q

dr. fowlers study: SIP teeth, inject normal 2% lido via IAN, if there is pain use buccal articaine. rank success of first molars, 2nd molars, premolars

A

73% premolars
48% second molars
42% first molars

PREmOLARS WORKED BEST

44
Q

does adding nitrous make patients think the block worked better

A

yep

45
Q

what is the mechanism of oraverse

A

a-adrenergic antagonist, vasodilator of vascular smooth muscle

46
Q

max dose of oraverse

A

2 carps

47
Q

does oraverse work

A

ya statistically significant

ENDO II (11 decks)

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