牙体牙髓病学的局部麻醉课件.ppt

* Usually give at least two for RCT – sometimes three. How to tell if they have profound anesthesia? feel heavy lip feeling. Use septocaine.. Then give infiltration as well, PDL.. * * Go a little higher if it fails at first. 27 gauge is best. Can start with a 30 guage and give a little … then go to the 27.. * Always aspirate first… bc highly likely that u might hit a vein. * * Pinpoint where condyle is and aim with neck of the syringe.. Go in around MP cusp of maxillary second molar. Then sit patient upright for a couple minutes… let anesthetic diffuse down. * * Don’t have to have something like this.. But it is pretty effective – delivers high pressure. * * Patient who is not responding to normal techniques.. This goes right through the bone. Consists of several parts. On left ? goes into handpiece… drills hole into bone then put needle in and inject right next to the tooth. Only use if patient is really hard to get numb… * Place distal to the tooth you want to treat. Make sure you have enough space so u don’t drill into root of a tooth. * If you notice overflow --- then it isn’t working. Need back pressure to work. The other system consists of a plastic sleeve that stays in the hole… easier than first. * * Newest technique… Pedal operated… drills into the bone and then when you push another lever, anesthetic flows right through drill beat. * * 30 gauge needle. Works with backpressure.. Needs to engage… Warn patient – it will pinch for a second… then will be fine. It is not very comfortable initially.. Action of back pressure – killing the nerve is causing the anesthesia not the anesthetic itself. * Septocaine more profound according to some studies.... * Questions of parasthesia with use of septocaine… no more likely than regular lidocaine. Septocaine used more than lido in Europe.. * Given as injection. Some patients want to be able to speak etc… soon after therapy. * Local Anesthesia in Endodontics Michael Moreno, DMD