Local anesthesia /certified fixed orthodontic courses by Indian dental academy


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  • Local anesthesia /certified fixed orthodontic courses by Indian dental academy

    1. 1. LOCAL ANESTHESIA INDIAN DENTAL ACADEMY Leader in continuing dental education www.indiandentalacademy.com www.indiandentalacademy.com
    2. 2. DEFINITION ‘ ‘Local anesthesia has been defined as a loss of sensation in a circumscribed area of the body caused by a depression of excitation in nerve endings or an inhibition of conduction process in peripheral nerves.” www.indiandentalacademy.com
    3. 3. METHODS OF INDUCING LA: • • • • • • Mechanical Trauma Low temperature Anoxia Chemical irritants Neurolytic agents (alcohol & phenol) Chemical agents(local anesthetics) www.indiandentalacademy.com
    4. 4. IDEAL PROPERTIES OF LA • It should not be irritating to the tissues to which it is applied. • It should not cause any permanent alteration in the nerve structure. • Its systemic toxicity should be low. • It must be effective regardless of whether it is injected to the tissues or applied locally to the mucous membranes. • Time of onset of anesthesia should be as short as possible. • Duration of action must be long enough to permit completion of the procedure yet not so long as to require an extended recovery. www.indiandentalacademy.com
    5. 5. • It should have potency sufficient to give complete anesthesia without the use of harmful concentrated solutions. • It should be relatively free from producing allergic reactions. • It should be stable in solution and readily undergo biotransformation. • It should either be sterile or capable of being sterilized by heat without deterioration. www.indiandentalacademy.com
    6. 6. CONCEPT OF ACTION OF LOCAL ANESTHETICS: • Local anesthetics prevent both the generation and conduction of nerve impulse. • They set up a chemical road block between the source of impulse and the brain. www.indiandentalacademy.com
    7. 7. ANOTOMY OF NERVE: NERON OR NERVE CELL: •Cell body •Axon •Dendrites SENSORY NERVE www.indiandentalacademy.com
    8. 8. MOTOR NERVE www.indiandentalacademy.com
    9. 9. NERVE MEMBRANE: Sensory nerve excitability and conduction are attributable to changes developing with in the nerve membrane. Proteins are classified as transport proteins and receptor proteins. www.indiandentalacademy.com
    10. 10. •MYELINATED NERVE •UNMYELINATED NERVE MYELIN SHEATH: •75% lipids •20% proteins •5% carbohydrates Node of Ranvier – are constrictions located at regular interval- 0.5 to 3mm. www.indiandentalacademy.com
    11. 11. CLASSIFICATION OF NERVE FIBRES: www.indiandentalacademy.com
    12. 12. NERVE TRUNK: www.indiandentalacademy.com
    13. 13. ELECTRO PHYSIOLOGY AND CHEMISTRY OF NERVE CONDUCTION: www.indiandentalacademy.com
    14. 14. • RESTING STATE: Nerve membrane is Slightly permeable to sodium ions Freely permeable to potassium ions Freely permeable to chloride ions • DEPOLARIZATION – 0.3msec • REPOLARIZATION – 0.7msec www.indiandentalacademy.com
    15. 15. • The firing threshold is actually the magnitude of decrease in negative transmembrane potential that is necessary to initiate action potential. • A decrease in negative transmembrane potential of 15 mV is necessary to reach the firing threshold. • Exposure of nerve to local anesthetic raises its firing threshold. www.indiandentalacademy.com
    16. 16. MEMBRANE CHANNELS: • Lipoglycoprotein aqueous pores firmly situated in the membrane. • Internal diameter – 0.3nm to 0.5nm. • Hydrated sodium ions have radius of 3.4 AO www.indiandentalacademy.com
    17. 17. • The nerve membrane. • Sodium receptor channel. www.indiandentalacademy.com
    18. 18. IMPULSE SPREAD: Slow forward creeping conduction Saltatory conduction www.indiandentalacademy.com
    19. 19. MODE OF ACTION OF LOCAL ANESTHETICS: • Alter the basic resting potential potential of nerve membrane. • Alter the threshold potential • Decreasing the rate of depolarization • Increasing the rate of repolarization www.indiandentalacademy.com
    20. 20. CLASSIFICATION BASED ON CHEMICAL STRUCTURE • ESTER GROUP A) Benzoic acid esters 1) Cocaine 2) Benzocaine B) Para amino benzoic acid esters 1) Procaine 2) Tetracaine 3) Propoxycaine 4) 2-Chloroprocaine www.indiandentalacademy.com
    21. 21. • NON ESTER GROUP A) Anilide 1) Bupivacaine 2) Etidocaine 3) Lidocaine 4) Mepivacaine 5) Prilocaine 6) Articaine 7) Ropivacaine 8) Dibucaine B) Quinoline 1) Centbucridine www.indiandentalacademy.com
    22. 22. BASED ON DURATIOIN OF ACTION A) Ultra short acting – Less than 30 mins. 1) Procaine 2) 2- Chloroprocaine with vasoconstrictor 3) 2% Lidocaine 4) 4% Prilocaine B) Short acting – 45-75 mins 1) 2% Lidocaine with 1:1,00,000 Epinephrine 2) 2% Mepivacaine with 1:20,000 Levonordephrin 3) 4% Prilocaine 4) 2% Procaine with vasoconstrictor www.indiandentalacademy.com
    23. 23. C) Medium acting – 90-150 mins 1) 4% Prilocaine with 1:2,00,000 Epinephrine 2) 2% Lidocaine with vasoconstrictor D) Long acting – 180 mins or longer 1) 0.5% Bupivacaine with 1:2,00,000 Epinephrine 2) 0.5% or 1.5% Etidocaine with 1:2,00,000 Epinephrine www.indiandentalacademy.com
    24. 24. BASED ON ACTION ON RECEPTOR SITE www.indiandentalacademy.com
    25. 25. www.indiandentalacademy.com
    26. 26. THANK YOU www.indiandentalacademy.com Leader in continuing dental education www.indiandentalacademy.com