mandibular anesthesia

Question 1

does lip numbness indicate pulpal anesthesia

Answer 1

not really

Question 2

do soft tissue sticks indicate pulpal anesthesia

Answer 2

no

Question 3

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

Answer 3

less than 80

anything higher than an 80 indicated pulpal anesthesia

Question 4

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

Answer 4

first premolar (60%)
first molar (55%)
lateral incisor (30%)

Question 5

is anesthetic failure in incisors and molars the same?

Answer 5

no

Question 6

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

Answer 6

lateral incisor (32%)
first molar (17%)
first premolar (11%)

Question 7

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

Answer 7

19-27%

Question 8

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

Answer 8

8%

Question 9

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

Answer 9

T

Question 10

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

Answer 10

false

Question 11

will plain mepivicaine/prilocaine work for an IAN block?

Answer 11

yep

Question 12

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

Answer 12

true

Question 13

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

Answer 13

SLOWER

Question 14

how long can you expect pulpal anesthesia with lidocaine

Answer 14

2.5 hrs

Question 15

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

Answer 15

4 hrs

Question 16

which lasts longer: lidocaine or marcaine

Answer 16

marcaine

Question 17

is articaine better for IAN than lidocaine

Answer 17

no

Question 18

success rate for lidocaine vs articaine in irreversible pulpits

Answer 18

basically the same, 24%

Question 19

when is articaine more effective than lidocaine

Answer 19

INFILTRATIONS, 3.55x more likely to work

no difference for IAN blocks

Question 20

paresthesia with articaine vs lidocaine

Answer 20

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

Question 21

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

Answer 21

no

Question 22

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

Answer 22

no

Question 23

will giving another IAN block help patients during treatment

Answer 23

not really

Question 24

does using a higher concentration of epi help with IAN efficacy

Answer 24

no

Question 25

does the mylohyoid nerve contribute to pulpal anesthesia

Answer 25

not significantly

Question 26

does lack of an accurate IAN injection cause failure

Answer 26

no? huh

Question 27

does accurate location of IAN bundle with ultrasound improve success

Answer 27

no

Question 28

does incorrect needle bevel orientation cause IAN failure

Answer 28

no

Question 29

does cross innervation cause the majority of failure in incisor teeth

Answer 29

no

Question 30

why dont patients get pulpal anesthesia with IAN injection?

Answer 30

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

Question 31

how to evaluate pulpal anesthesia before starting treatment

Answer 31

ice test

Question 32

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

Answer 32

consider using supplemental injections

Question 33

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

Answer 33

no, cold testing may not always indicate anesthesia for SIP

Question 34

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

Answer 34

slow

Question 35

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

Answer 35

yes

Question 36

is a PDL injections as successful as intaosseous

Answer 36

no

Question 37

extractions: success of mandibular molar extractions with IAN alone

Answer 37

74%

Question 38

extractions: success of mandibular molar extractions with IAN and intraosseous

Answer 38

95%

Question 39

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

Answer 39

yes (81% vs 65%)

Question 40

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

Answer 40

they aren't numb for an hour

Question 41

what is an option for mandibular anterior teeth

Answer 41

IAN plus labial infiltration of articaine

Question 42

does articaine infiltration work on a tooth with SIP

Answer 42

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

Question 43

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

Answer 43

73% premolars 48% second molars 42% first molars PREmOLARS WORKED BEST

Question 44

does adding nitrous make patients think the block worked better

Answer 44

yep

Question 45

what is the mechanism of oraverse

Answer 45

a-adrenergic antagonist, vasodilator of vascular smooth muscle

Question 46

max dose of oraverse

Answer 46

2 carps

Question 47

does oraverse work

Answer 47

ya statistically significant