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Supplemental injection techniques

Supplemental injection techniques. Dr.Soukaina Ryalat. Main types. PDL injection Intraosseous Intraligamental Intra pulpal. Development of Instruments. PDL injection. Localized anesthesia 74% of patients prefer PDL over the inferior alveolar anesthesia

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Supplemental injection techniques

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  1. Supplemental injection techniques Dr.Soukaina Ryalat

  2. Main types • PDL injection • Intraosseous • Intraligamental • Intra pulpal

  3. Development of Instruments

  4. PDL injection • Localized anesthesia • 74% of patients prefer PDL over the inferior alveolar anesthesia • No soft tissue anesthesia ( tongue ,lip are spared)

  5. Indications of PDL • Treatment of isolated teeth. • In pediatric treatment • When I.D block is contra indicated (Hemophilics) • Diagnosis of mandibular pain • To avoid bilateral I.D block anesthesia

  6. Contraindication • Presence of infection • Concerns about enamel hypoplasia • Soft tissue damage,crestal bone resorption, safety of periodontium????

  7. Equipments • Extra short needle is required (30 or 27 gauge) • Special needle??

  8. Periodontal ligament injection • Technique: • A 27-gauge short needle • Area of insertion: long axis of the tooth to be treated on its mesial or distal of the root, or on the mesial and distal roots interproximally • Target area: depth of the gingival sulcus • Two important items indicate the success of the injection: • Significant resistance to the deposition of the solution • Blanching of the soft tissues adjacent to the injection site

  9. Intraseptal injection

  10. Intraseptal Injection • Indications: When both pain control and hemostasis are required for soft tissue and osseous periodontal treatment • Contraindications: Infection at the injection site • Areas anesthetized: Bone, soft tissue and root structure at the injection area

  11. Intraseptal Injection • Technique: • A 27-gauge short needle • Area of insertion: center of the interdental papilla adjacent to the tooth to be treated • Two important items indicate the success of the injection • Significant resistance during injection • Blanching of soft tissues adjacent to the injection site

  12. Intraosseous Injection • Indication: pain control for dental treatment of single or multiple teeth in a quadrant • Areas anesthetized: Bone, soft tissue and root structure at the injection area

  13. Intraosseous Injection • Technique: Site of injection: at a point 2 mm apical to the intersection of lines drawn horizontally along the gingival margins of the teeth and a vertical line through the interdental papilla The site should be distal to the tooth to be treated

  14. Intra pulpal Anesthesia

  15. Additional maxillary techniques • Anterior middle superior alveolar nerve block • Palatal approach – Anterior superior alveolar nerve block

  16. AMSA- Nerve Block • Developed 1n 1997 by Friedman and Hochman • Area of Anesthesia; • ASA nerve • MSA nerve • Subneural dental nerve plexus

  17. Contraindications • Patients with thin palatal mucosa • Patients who cant tolerate 3-4 m administration time. • Procedures requiring more than 90 minutes.

  18. PA-ASA nerve block • Nerves Anesthetised: • Nasopalatine • Anterior branches of ASA nerve

  19. Maxillary nerve block • High tuberosity approach • Greater palatine canal approach

  20. Thank you • Good luck

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