LA Sheet #13 By Ruaa Rawa Al-Yhya

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LA Sheet #13 By Ruaa Rawa Al-Yhya

Post by Sura on 2/1/2012, 10:52 pm

http://www.mediafire.com/?ff0fi4tpm4ki648
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Re: LA Sheet #13 By Ruaa Rawa Al-Yhya

Post by Shadi Jarrar on 15/1/2012, 3:08 pm

Supplemental injection techniques
Supplemental injection techniques are:
■periodontal ligament injection "PDL"
■intra-osseous injection
■intra-ligamental injection
■intrapulpal injection
Periodontal injection
There are different types of syringes one of these is gun-like syringe this type is specific for PDL injection, main disadvantage of gun like syringe is very expensive, used mostly in pediatric patient
►it is localized anesthesia
►74% of patients prefer PDL injection upon ID block, because of it is lack of lingual and labial soft tissue anesthesia
►NO soft tissue anesthesia "no tongue or lip anesthesia" (LOCALIZED)
Q/why we use PDL in PEDIATRIC patient?
Answer: because with ID block soft tissue anesthesia present leading to soft tissue trauma induced by the child himself "the child keep biting on his/her anesthetized soft tissue"
Note: some patient don’t like ID block since it is so annoying so PDL use as alternative for ID block in those patients
Indications for PDL injection
A-treatment of isolated tooth
B-in pediatric patients "since residual soft tissue anesthesia increases the risk of self mutilation"
C-when ID block is contraindicated
Q) When ID block is contraindicate
Answer: blood disorders especially bleeding disorder (hemophiliacs'), don’t give them ID block because if u did u can enter vessel leading to hematoma
NOTE: hemophilics patient don’t ever give them ID block or injection in the floor of the mouth
D-Diagnosis of the mandibular pain "if there is pain in the mandible to diagnose this pain we need to reaches the source of the pain se we give localized anesthesia →SO PDL injection is the choice in this case.
E-To avoid bilateral ID block anesthesia: in case u want to extract lower right and left six, it is contraindicated to give bilateral ID block, so you give ID on one side and PDL to the opposite side to avoid bilateral ID block
Q) Why bilateral ID block is contraindicated?
Answer: ID block on both side will be miserable, ↑ risk of trauma
Contraindications:
1-presence of infection, whenever there is infection don't give anesthesia because this will disaminate the infection
2-soft tissue trauma and crestal bone damage
Complications:
1-Concerns with enamel hypoplasia, this technique used mostly in children(we are talking about D,E below them there are first and second premolars) there are a lots of studies about the deposition of the anesthetic solution in the area of E,D can go directly to the first and second premolars "growing teeth" causing enamel hypoplasia
2-Evulsion of the tooth; inserting the needle in the PDL space
High pressure→ leading to tooth evulsions "very very rare"
3-If there are problems with the soft tissue crestal bone, this injection can worse the problem
##Armamentarium:
1) Special syringes
2) Special needle "extra short needle"
## Area anesthetized: bone, apical and pulpal tissue in the area of injection

Technique:
A-27 gauge or 30 "extra short needle" is recommended
B-area of insertion: perpendicular to dental papilla, along the long axis of the tooth to be treated on its mesial or distal of the root OR on it is mesial or distal roots interproximally
C-target area: depth of gingival sulcus
E-there are two important indicators of success of the injection: 1→significance resistance to the deposition of the solution 2→blanching of the soft tissue adjacent to the injection site "very important"
Intraseptal injection
Deposition of anesthetic solution into bony septum between the teeth
►Landmark: papilla
●intraseptal is same when we say intaosseous
Indications:
→both pain and homeostasis are required in soft tissue and osseous periodontal
Contraindications: infection
Area anesthesized: soft tissue, bone, and root structure in the area of injection
Technique:
-27 guage short needle
-area of insertion: center of the interdentalpapilla adjacent to the tooth to be treated
-2 items indicate successful of the injection:
1→resistance during injection 2→blanching of the soft tissue adjacent to the injection site
◘NOTE: in the interseptal injection we can use needle or round bur "we do little drilling after that we insert the needle"
Intra-pulpal injection
Deposition of local anesthetic directly into the pulp chamber under pressure to control the pain
►this is the only type of injection that u BEND the needleg
THE END
Done by: Ruaa Rawa
Date of the lec.:28/12/2011
Dr.Sukaina Ryalat
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Shadi Jarrar
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تاريخ التسجيل : 2009-08-28
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الموقع : Amman-Jordan

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