mandibular anesthesia Flashcards
does lip numbness indicate pulpal anesthesia
not really
do soft tissue sticks indicate pulpal anesthesia
no
electric pulp test readings less than ____ resulted in pain during restorative procedures
less than 80
anything higher than an 80 indicated pulpal anesthesia
rank from most successful to least successful pulpal anesthesia via IAN block with 1 carp lido: lateral incisor, first premolar, first molar
first premolar (60%) first molar (55%) lateral incisor (30%)
is anesthetic failure in incisors and molars the same?
no
what tooth is most likely to have anesthetic failure after IAN block?
lateral incisor (32%) first molar (17%) first premolar (11%)
slow onset of anesthesia in mandibular teeth occurs ______% of the time
19-27%
what percentage of mandibular teeth won’t have anesthetic onset until 30-50 mins later
8%
t/f: duration of pulpal anesthesia in mandibular teeth is very good for patients who initially achieve anesthesia
T
t/f: it doesn’t matter if you have had previous difficulty with getting numb
false
will plain mepivicaine/prilocaine work for an IAN block?
yep
t/f: 3% mepivicaine with NO epi is as effective as regular lido with 1:100k epi in IAN block
true
bupivicaine w/ 1:200k epi (marcaine) has a slower or faster onset than lidocaine w/ 1:100k epi
SLOWER
how long can you expect pulpal anesthesia with lidocaine
2.5 hrs
how long can you expect pulpal anesthesia with bupivacaine (marcaine)
4 hrs
which lasts longer: lidocaine or marcaine
marcaine
is articaine better for IAN than lidocaine
no
success rate for lidocaine vs articaine in irreversible pulpits
basically the same, 24%
when is articaine more effective than lidocaine
INFILTRATIONS, 3.55x more likely to work
no difference for IAN blocks
paresthesia with articaine vs lidocaine
5x more likely with articaine, but incidence is less than 1 in 785,000
are gow-gates/akinosi superior to the standard IAN block?
no
does increasing the volume of lidocaine injected increase indidence of pulpal anesthesia with IAN block
no
will giving another IAN block help patients during treatment
not really
does using a higher concentration of epi help with IAN efficacy
no
does the mylohyoid nerve contribute to pulpal anesthesia
not significantly
does lack of an accurate IAN injection cause failure
no? huh
does accurate location of IAN bundle with ultrasound improve success
no
does incorrect needle bevel orientation cause IAN failure
no
does cross innervation cause the majority of failure in incisor teeth
no
why dont patients get pulpal anesthesia with IAN injection?
anesthetic solution may not diffuse into the nerve trunk to reach all the nerve bundles
how to evaluate pulpal anesthesia before starting treatment
ice test
if a patient responds with ice response after numbing them up…
consider using supplemental injections
t/f: if a patient is experiencing SIP, after you numb them up and get a negative ice test you are good to go
no, cold testing may not always indicate anesthesia for SIP
which is more effective: a slow 60 sec IAN injection or a rapid 15 sec injection
slow
does adding on a PDL injection increase success of IAN blocks with pulpal anesthesia
yes
is a PDL injections as successful as intaosseous
no
extractions: success of mandibular molar extractions with IAN alone
74%
extractions: success of mandibular molar extractions with IAN and intraosseous
95%
is articaine statistically superior to lidocaine in buccal infiltrations of mandibular first molars
yes (81% vs 65%)
you can get a good success rate with just labial and/or lingual infiltrations of articaine in mandibular anterior teeth but….
they aren’t numb for an hour
what is an option for mandibular anterior teeth
IAN plus labial infiltration of articaine
does articaine infiltration work on a tooth with SIP
not that great (24-58% success), intraosseous is better
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
73% premolars
48% second molars
42% first molars
PREmOLARS WORKED BEST
does adding nitrous make patients think the block worked better
yep
what is the mechanism of oraverse
a-adrenergic antagonist, vasodilator of vascular smooth muscle
max dose of oraverse
2 carps
does oraverse work
ya statistically significant
