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Anesthesia

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Anaesthesia & Exodontia …

Anaesthesia & Exodontia
Third Year

Published in: Education, Business, Technology

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  • 1. :Intraoral techniques- 1 a) Local infiltration of nerve endings (submucosal ). analgesia b) Block of the terminal branches (infiltration ). anesthesia c) Anterior and middle superior alveolar nerve block ).(infraorbital
  • 2. :Intraoral techniques- 1 d) Posterior superior alveolar nerve block ).(zygomatic e) Nasopalatine nerve block (incisive canal ).injection .f) Anterior (greater) palatine nerve block .g) Maxillary nerve block
  • 3. :Extraoral techniques- 2 a) Anterior and middle superior alveolar nerve block ).(infraorbital .b) Maxillary nerve block
  • 4. .Nerves anesthetized .Areas anesthetized .Anatomical landmarks .Indications .Technique :Symptoms of anesthesia .a) Subjective symptoms .b) Objective symptoms
  • 5. Basic Injection Technique Position the patient Communicate with the patient Prepare the tissue Dry the area Apply antiseptic Apply topical anesthetic Check flow of local anesthetic       
  • 6. Maxillary Injection Techniques Nerve Block Posterior superior alveolar nerve block Middle superior alveolar nerve block Anterior superior alveolar nerve block Maxillary (second division) nerve block Greater (anterior) palatine nerve block Nasopalatine nerve block      
  • 7. Maxillary Anaesthesia  Maxillary bone is porous and mainly cancellous.  Roots of the maxillary teeth are covered only by a thin layer of buccal bone.  Highly vascular
  • 8. Maxillary nerve distribution and LA .:Infiltration A • Buccal Infiltration Palatal Infiltration – – .:Block A • Posterior superior alveolar NB Middle superior alveolar NB Infra orbital NB (Int. Ext. ).oral Greater Palatine NB Nasopalatine NB ).Maxillary NB (Int. Ext. oral – – – – – –
  • 9. Maxillary infiltration anaesthesia .:Buccal Infiltration A. 1 For all Maxillary teeth Slow supraperiosteal injection Opposite to the tooth apex, at a point made by the long axis of the tooth and the buccal vestibule Needle bevel toward the bone Onset is 3-5mn. and working .time is 20 – 30 minutes – – – – –
  • 10. .Maxillary labial infiltration A. 2 Opposite to the – tooth apex, at a point made by the long axis of the tooth and the labial vestibule
  • 11. Palatal Anaesthesia )(infiltration & block  Nasopalatine nerve  infiltration  block  Greaterpalatine nerve  infiltration  block  No need for lesser palatine A.
  • 12. Infiltration - Palate Nerves Terminal branches - Greater Palatine nerve Nasopalatine nerve Area Palatal soft tissue in area of injection     
  • 13. Infiltration - Palate Indications Limited area Hemostasis Contraindications More than 2 teeth Inflammation/infection at site Advantages  Hemostasis   Minimal area affected Disadvantages  Potentially  traumatic      
  • 14. Infiltration - Palate Technique Apply topical, pressure Insert into gingiva in center of area mm from gingival margin 5-10(Aspirate (positive results are rare Inject 0.2-.3 ml, slowly      
  • 15. Failures of Anesthesia Quite rare Failure of hemostasis Inflammation Lack of vasoconstrictor    
  • 16. Complications Necrosis or sloughing of the palatal soft  tissue (due to excess vasoconstriction (
  • 17. Greeter palatine nerve block Between upper  2nd and 3rd molars. Midway between the median palatine raphae and the free .gingival margin
  • 18. Posterior superior nerve block Distal to the 2nd molar, posterior to the tuberosity, at 45 degrees  Aspirate first, Pterygoid plexus of veins. Maxillary N B Post. Sup. Alv.NB Maxillary infiltration
  • 19. Posterior Superior Alveolar Nerve Block :Nerve Anesthetized  Posterior Superior  (Alveolar Nerve (PSA For maxillary molars  and buccal tissue
  • 20. Indications for PSA Block First or second maxillary molar Supraperiosteal injection has proved ineffective Contraindication Risk of hemorrhage is too great (eg. hemophilia, coumadin(     