Professional Documents
Culture Documents
neck
Pain Control
Techniques for Local Anesthesia for the
head and neck
Turki Alkhallagi
Mohammad Basabreen
Wejdan Asiri
Asmaa Bukhari
Sumayah Halabi
Eshrag Al-Shangiti
2009
Topical Anesthesia:
Paste, volatile liquid, solution, lozenge, mouthwash;
skin, mucous membranes & renders the area insensible.
Submucous
Subperiosteal
Paraperiosteal
Periodontal (Intraligamental)
Papillary
Field (ring) block
Jet injection
Intrapulpal
iii.
1) Area to be anesthetized:
Maxilla + Mandibular anterior region infiltration
Mandibular posterior region nerve block
2) Extent of surgical Procedure:
Single extraction Infiltration
Multiple extractions, large amount of solution, several punctures, large area N.B.
3) Duration & profoundness of anesthesia required:
Larger time + prof. anesthesia N.B.
Otherwise infiltration
4) Age of patient
Older: dense bone N.B.
Younger: less dense bone infiltration
5) Hemostasis if needed:
If needed infiltration
If not N.B.
6) Presence of presence of infection:
Inflamed area N.B.
No infection infiltration
7) Skill of operator.
a)
b)
c)
d)
A. Preanesesthetic evaluation:
Pregnant
Diabetic
thyrotoxic
o Patients fit.
B. Preanesesthetic preparation:
Syringe
Capsule
Operator hands
Patients mouth (scaling)
Site of injection
C. Injection Technique:
For a maximum effect. The injected L.A. must come into
contact at least 8-10 mm. of the nerve to block 2,3 nodes of
Ranvier.
Indication:
Max. teeth (long buccal & cutaneous coli)
Lower ant. Teeth
Method:
Max. - Buccal side\
Retraction of lip & cheek till it makes right angle with alveolar mucosa. Bevel the
needle 45 degree to the floor & insert it while holding as pin grasp in the
intersection of the mucobuccal fold (vesibulo-sulcus)and the dissecting line of the
tooth which will be the level of the apices of the upper teeth. Insert the needle
about 2mm till it touches the bone.
This will Anesthetizes the pulp, periodontal ligament, buccal and palatal cortical
bone, and buccal mucoperiostium
1.6 of the carpule
Tooth
CentralsCani
ne
Premolar
Labial innervation
Ant. Sup. Alveolar n.
Palatal innervation
Nasopalatine
Molars
Technique:
o Using one inch 27 gauge needle
o 5 min for maximum anesthesia
o 45 min duration
o Avoid ballooning the area, - slow
injection
N.B.\
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