Supplemental Techniques

Question 1

What are supplemental techniques of Intra-osseous anaesthesia?

Answer 1

• Intraligamentary / periodontal ligament injection
• Direct injection into Bone e.g. Stabident

Question 2

What is the Intraligamentary Anaesthesia technique?

Answer 2

• high pressure
• low volume
• short needle

Needle between tooth and crestal bone: ~0.2ml/root over ~20s

Question 3

What is the mode of action for Intraligamentary Anaesthesia?

Answer 3

Mode of action: spread of solution out of PDL to cancellous bone - more likely = INTRAOSSEOUS

Question 4

What are the Intraligamentary Anaesthesia Advantages?

Answer 4

low dose (0.2ml per root)

rapid on set

little soft tissue anaesthesia

bleeding problems - ? alternative to IAB

Question 5

What are the Intraligamentary Anaesthesia Disadvantages?

Answer 5

? PDL damage

post-injection pain

Not always effective

Short/variable duration

Tooth extrusion

Significant bacteraemina - not suitable if endocarditis risk

Technique sensitive

Question 6

What is Intra-papillary Anaesthesia and how does it work?

Answer 6

• Comfortable palatal anaesthesia
• Useful for children
• Buccal / labial infiltration first
• Intrapapillary injection:

– Papilla

– Slowly advance from Buccal to Palatal

– Inject as advance the needle

– Palatal blanching

Question 7

What is Akinosi Injection technique?

Answer 7

• High Block
• Closed mouth
• Needle entry above 7’s
• Pass back ~2.5cm

Question 8

What is the Topical Anaesthetic - Intra-periodontal pocket?

Answer 8

• Oraqix™
• Mixture of:

– Lidocaine 2.5% (=25mg/ml)

– Prilocaine 2.5% (=25mg/ml)

• No needles
• Do not inject it
• Thermosets: – viscous liquid to a gel in pocket
• Useful for RSI / RSD