Circulatory Shock, types and stages, compensatory mechanisms
LA part 3
1. 1
Chapter 3
Dr/Atef fouda
Prof. Oral & Maxillofacial Surgery
Cairo University
Egypt
Innervations of dental
structures.
Armamentarium used for
local anesthesia.
Method of L.A
administration “Techniques”.
8. Accessory innervations
In some cases the left
anterior superior alveolar
nerve supplies the right
pulp & supporting
structures and labial
mucosa of anterior teeth
i.e central incisor, lateral
incisor and canine teeth.
RT LT
14. Trigeminal ganglion
Mandibular nerve
Anterior divisionPosterior division
Inferior alveolar N.
Incisive N.
2 1
4
3
6 58 7
Pulp & Supporting structures of mandibular teeth
Mental N.
Lingual N.
Long buccal N.
21. help in tissue penetration.
Bevel
shank
determines the needle length
Hub
fixes the needle to the syringe.
cartridge end of the needle
fixes the needle inside the cartridge
Parts of the needle
1-Needles.
23. Length:
Long = 32 mm:
Short = 20 mm:
Ultra short = 10 mm:
Shank length
1-Needles.
24. Gauge:
20 gauge 0.81 mm. diameter.
21 gauge 0.72 mm. diameter.
22 gauge 0.64 mm. diameter.
23 gauge 0.57 mm. diameter.
24 gauge 0.51 mm. diameter.
25 gauge 0.45 mm. diameter.
27 gauge 0.40 mm. diameter.
1-It is rigid enough to be guided
directly to the target area
without deviation.
2- It is less likely to penetrate
small blood vessels.
Shank Lumen diameter
1-Needles.
25 gauge long needles.
3-Aspiration is much easier and certain through the larger lumen.
4-It is safer because breakage is less likely to occur.
25. 1-Needles.
Needle label
Certified
2 Not to be used twice.
Sterile EO Sterile and sterilized with Ethylene Oxide Gas sterilization
27Gauge & 35mm Represents the lumen diameter and length in mm.
30. 4-The vasoconstrictor.
5-A preservative for the vasoconstrictor ”sodium bisulfite”.
Contents of the anesthetic carpule:
2-Cartridges.
1-The anesthetic drug.
2- Sodium chloride to make the solution isotonic.
3-Distilled water to complete the desired volume of the carpule.
Plain anesthetic carpule:
Anesthetic carpule with vasoconstrictor
31. 2-Cartridges.
Anesthetic drug concentration
4% LA = 40 mg of LA/ml
Carpule = 1.8 carpule = 40 X 1.8 = 72 mg of LA.
Anesthetic drug concentration measured by percentage
concentration of the drug in the solution
2% concentration = 20 mg of LA/ml
Carpule = 1.8 carpule = 20 X 1.8 = 36 mg of LA.
3% LA = 30 mg of LA/ml
Carpule = 1.8 carpule = 30 X 1.8 = 54 mg of LA.
Carpule volume: 1.8 ml
37. 3-Syringe:
which carry the anesthetic carpule.
2-Syringe barrel
Components of dental syringe:
1-Hub
for receiving the dental needle.
3-Fingers rest
syringe support during injection.
38. 4-Piston of the syringe
Piston either end with flat metallic
disc to push the cartridge rubber
stopper and subsequently the
anesthetic solution to be finally
extruded from the needle at the other
end or end with harpoon that could be
fixed to the rubber stopper of the
carpule to help in its retraction and
aspiration through the needle.
3-Syringe:
5-Thumb rest [Ring]
Pushing the piston using the operator’s thumb.
42. liquids forced through very small
openings, called
jets at very high pressure [2000 psi]
can penetrate
skin or intact mucous membrane
Syrijet holds any 1.8 ml cartridge of
local anesthetic
*Jet Syringes ($1,600)
needle-less injection
3-Syringe:
Jet syringe
45. TOPICAL ANESTHESIA
Used before injection to decrease pain from needle
puncture. It may be in form of jel or spray.
Be carful from toxicity if the area of application is
injured.