insturments & techniques of local anaesthesia

8/4/2019 Insturments & Techniques of Local Anaesthesia

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Insturments & techniques of LA


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Requirements of good LA

Good accessability

Good light

Proper equipments

Sharp gauge

Slow injection even under sedation...this

will decrease pain & prevent the directionof the solution rapidly to the heart in case ofintravascular injection


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Anesthetic Gel

Local anesthesia kit

Anesthetic solution= carpool

Gauze

Syringe

Cotton tip

NeedlesShort

Long


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Local anesthesia

Cardboard needlecap-holding device makes recapping needles safer


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Before the injection, the patient needs

topical anesthesiaAdvantages of TA

Decreases the risk of toxicity

Provides comfortabel anesthesia


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Types of topical anesthesia

Spray

Ointment

Gel

Oral rinse anesthesia

MUST DRY FIRST, will not work with

saliva


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Spray

Spray into the

cotton roll

Place over drymucosa

Wait for 1 min


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Ointment


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Gel

Effective as the ointment

Applied to the cotton roll

Then apply on a dry mucosa for 1 min


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Oral rinse anesthesia

Used for very sensitive

patients that do not allow

any touch in the mouth Let the patient rinse for 2

min

Then you can give the

injection


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Insturments of LA

Mirror: for retration

Probe: for insturmentation

Syringe

Needle; short& long


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Types of syringes according to

manufactures


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Disposable syringes

Single use


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Sterizable syringes

Multiple use Made of metal\lasts for long

Firm

No breakage if the patients bites suddenly


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Types of syringes according to the

method used

Aspirating syringe,

for nerve block Infilteration syringe


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What is aspiration?

For the nerve block,

always aspirate (pull in) to

ensure your needle is notinside the artery

If inside blood will come

in the carpule

If nothing, the needle is inthe right place


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Needles

Short

Long

Bevel towards the

tissue


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Types of LA

Local infiltrationSmall terminal nerve endings in the area of the

dental treatment are flooded with LA solutionMainly in maxilla

Nerve blockLocal anaesthetic solution is deposited close to

the main nerve block, usually at a distance fromthe operation site

Mainly in mandible


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Choice the method of LA technique

The ideal method is the

Simplest

Least traumatic

Require a minimum amount of LA solution

This depends on several factors.....


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Factors that affect the choice of

the method of LA technique The area to be anesthetised

Type of tissue to be anesthetized

Potency & duration of LA

Age of the patient

Presence of infection??

Need of haemostasis

Systemic condition of the patient


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MAXILLARY TECHNIQUES

OF LA Local infiltration

Nasopalatine nerve block

Greater palatine nerve block


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Local infiltration

Very useful for the maxilla bcz of its porosity

For the mandible its difficult bcz denseness

In the mandible, infilteration can be used foryoung individuals, 6 anterior teeth, teeth with

resorbed bone

I fil i i h ill


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Infiltration in the maxilla


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Local infiltration

Indications:

1 or 2 maxillary teeth

Will aneasetize thepulp, alveolar bone,

buccal periostium,

connective tissue,

mucose membrane of

the infilterated teeth

Contraindication:

Presence of infection


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Local infiltration

The needle should be 45

degree to tooth, bone

Bevel towards bone Opposite to the tooth

Inserted the whole depth of

the mucobuccal fold close

to the root apex


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Nasopalatine nerve block


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Greater palatine nerve block


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MANDIBULAR TECHNIQUES Of

LA IANB

Mental nerve block


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Inferior alveolar nerve block

The primary injection for themandible

Always associatedwithbuccal nerve blocks

It provides Pulpal anaesthesia of

mandibular teeth Soft and hard tissue of themandible


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Inferior alveolar nerve block

The foramen can be palpated half way between the last (3rd)molar and the angular process

The needle is directed with the forefinger and inject the solution
http://www.vet.ed.ac.uk/clive/cal/Dentistry/Website/Media/Extraction_Media/bigger_pics/InjLocalMand2.jpg


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Mental nerve block

The mental nerve emerges

from the mental foramen,

which lies between the pms Indications: anterior aspect

of the mandible


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Other LA techniques

Can be used as a suppliment to other

techniques, infiltration or nerve block

For the mandible or the maxilla

2 main types: intrapulpal & interligamnetary


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Intrapulpal injection

Indications: after pulp

exposure, sever pain the pt

will jump!!

The effect is in 2 ways: Pharmacological action of

LA

By the applied pressure


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Intraligamintary (PDL) injection

A short needle should bebended first

The needle is placed

firmly between the PDLand the tooth to beaneasthetized

Insert the needle bevel

towards the tooth 0.2-0.3 ml is deposited at

all sites of the tooth


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Intraligamintary PDL injection


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EXTRA ORAL TECHNIQUES

Upper lip aneathesia

Lower lip aneathesia

Infraorbital nerve block


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Wy do we need EXTRAORAL technique??

Trauma

Severe infection


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Upper lip anesthesia

Upper lips areanesthetized from twopoints, one on each side

of the angle of themouth

5 to 10 mL of anestheticis injected along twolines in the direction of

the nasal alae.


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Lower lip anesthesia

The needle is injected at

the midpoint of the chin

and soft tissues are

infiltrated obliquelyupward toward the angle

of the mouth

A total of 10 to 15 mL of

anesthetic generally isrequired.


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Infraorbital Nerve Block

The infraorbital nerve supplies

The central area of the face (upper lip, cheeks, the

external nose)

The needle is inserted approximately 1 cminferior to the infraorbital foramen and

advanced upward toward the foramen

The needle is directed upward and laterally to

avoid passing through the foramen into theorbit


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Infraorbital Nerve Block


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Dont forget..!!


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Remember

Dont show the patient your needle...


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Thank you..

insturments & techniques of local anaesthesia

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