Anesthetics are used for many dental problems. Its type is chosen based on the type of procedure. Infiltration anesthesia is often used, which provides effective pain relief. Its features and types are described in the article.
What is this?
Infiltration anesthesia is a type of anesthesia used in dentistry in the treatment of teeth and other parts of the oral cavity. With it, blocking of the nerve endings of the operated site occurs with the help of an anesthetic injection. The drug can be injected into different parts of the mouth, it all depends on the goals.
Based on the injection area, infiltration anesthesia can be direct and indirect, which, compared to the first type, anesthetizes the dental plexus. The direct method is intended for procedures on the processes of the alveolar ridge or soft tissues. The indirect method is used for tooth extractions and jaw bone surgery.
In both cases, anesthesia blocks the nerve endings for several minutes. The difference is in the waydelivery means and the place of impact. An agent injected under the mucosa or into the periosteum is delivered to the vascular bundle. The anesthetic introduced into the bone impregnates the nearest bone tissue and nerve endings of the tooth, and then passes into the root canal. If the needle is brought close to the neurovascular bundle, then the drug will act quickly and effectively.
For lower jaw
In this situation, anesthesia is used only for short manipulations on soft tissues. If serious intervention is needed, it is combined with other types of anesthesia, which enhances the effect. This approach is associated with the structure of the jaw. The alveolar tissues of the lower jaw are dense and porous, so the anesthetic completely penetrates the nerve bundle.
The anterior section is considered to be the less dense part, where there are many micropores, so this anesthesia is used when manipulating the incisors. To stop the pain will allow the introduction of funds into the transitional fold. To anesthetize all incisors, an injection is made into the fold between the first incisors. The solution is then applied by moving the needle towards the canine.
On the upper jaw
Infiltration anesthesia is actively used in therapy and surgery of the teeth of the upper jaw. The injected agent quickly enters the nerve fibers due to the high porosity and small thickness of the jaw bone. If the manipulations will be performed on the incisors, the needle is inserted into the fold of the transition medial to the painful tooth and above the top of the roots.
To stop the pain from the sky, it is necessarycut off the mucous membrane at the site of the incisor opening. This is how anesthesia of the first premolar is performed. To anesthetize the nerve fibers of the molars, the second premolar, the needle is injected between the tooth and the adjacent premolar. It is also necessary to cut off the top of the angle from the alveolar and palatine processes.
Intraligamentary
This is a type of infiltration anesthesia in dentistry, in which the solution is injected into the ligaments of the tooth. The tool is injected under high pressure, so it accurately hits the bone of the alveolar ridge. This method has excellent efficiency and is used in serious dental procedures.
Intrapapillary
This type of anesthesia involves the introduction of an anesthetic into the interdental papilla. For this, a thin short needle is used, injected into the base of the papilla and advanced to the bone, and then the solution is released. A single injection does not provide a complete blockage of the nerve endings of the tooth, so an injection from the palatal part is required.
Subperiosteal
For this procedure, you need a syringe with a short needle, 3 cm long. It must be placed between the root base and the gum, choosing the point of transition of the movable mucosal area to the fixed one.
The drug is administered by sharply pressing the plunger. This manipulation requires a minimum of anesthetic, while absolute blockade of the nerves is performed in a short time.
According to Vishnevsky
Infiltration anesthesia according to Vishnevsky is special, with it the anesthetic enters the tissues in layers. Anesthesia of each layer occurs separately due to the "creeping infiltrate". This action is provided by introducing a solution under pressure. The agent is distributed through the tissues, therefore, contact with the nerves of the operated area is ensured.
Indications and contraindications
Local infiltration anesthesia can be used for:
- opening purulent abscesses;
- treatment of the lining of the oral cavity;
- mandibular anesthesia;
- removal of temporary teeth on two jaws;
- removal or treatment of permanent teeth in the upper jaw;
- mucosal suturing in case of injury.
This type of procedure should not be used in case of drug intolerance. In this case, the specialist will select the most effective method of anesthesia.
Pros and cons
This anesthesia is known for a number of advantages compared to other methods of pain relief:
- Easy technique as no precise anatomical orientation is required.
- There is a rapid arrest of the nerve fibers of the painful tooth and nearby tissues.
- You can use the minimum concentration of the agent, making this method safe.
Because of these benefits, the procedure is effective. In addition to the advantages, the technique also has disadvantages:
- A small area of anesthesia.
- Restriction for use on the lower jaw.
- Small pain relief.
Execution rules
The technique of infiltration anesthesia is the same, no matter what area it is injected into. The procedure is as follows:
- Aseptic treatment of the mucosa at the proposed injection site is carried out.
- After that, the dentist becomes to the right of the patient.
- With a finger or a mirror, the doctor pushes back the lip or cheek so that the transitional fold becomes exposed.
- The tip of the needle must be placed on the transitional fold at an angle of 45 degrees to the alveolar ridge. Its cut is turned to the jaw bone.
- Required to insert the needle into the tissue. It should be placed 5-15 mm, it all depends on the insertion site.
- Then the drug is injected.
This is the basis of infiltration anesthesia. Depending on the type of injection tissue, the drug is administered smoothly or quickly. If the procedure is performed by a specialist, no discomfort should occur.
In children
During the treatment of teeth in children, psycho-emotional overstrain usually occurs. They cannot be forced to endure pain, so this type of anesthesia is often used, as it helps to complete the full treatment and increase confidence in the doctor.
But due to the nature of the blood supply to the oral cavity, children often experience toxic manifestations from anesthetics, which parents usually associate with allergies. Since such reactions are considered contraindications, it is necessary to tell the dentist about the occurrence of side effects.
If children refuse to be treatedteeth and go to the dentist, throw a tantrum, anesthesia is often prescribed. But before agreeing to this procedure, which has a list of contraindications, you must consult another doctor. Children must have contact with the dentist and trust in him, and then the treatment will be successful.
Drugs
The most effective drugs include drugs with articaine:
- Ubistezin. It contains a vasoconstrictor component that provides a long and stable anesthetic effect.
- Ultracain. It is released with and without epinephrine. The drug should not be used in diabetes, hypertension, asthma.
- "Septanest". Includes epinephrine and preservatives not found in Ubistezin and Ultracaine.
- Orablock. The remedy is similar to Ubistezin.
Lidocaine and novocaine are not used in infiltration anesthesia. These drugs are toxic compared to anesthetics with articaine. Novocaine is powerless with purulent inflammation.
Probable Complications
Post-injection complication is pain in the injection area. It occurs when the needle is incorrectly inserted into the mucosa. If there is no appropriate aseptic processing, inflammation of the soft tissues with swelling and redness is observed.
If the symptoms do not disappear for several days and intensify, you need to contact a specialist. In the absence of professional help due to inflammation, exfoliation of the mucous membrane and periosteum appears, and this can cause necrosissoft tissues. Due to the purulent process, infection of the jaw bone occurs and osteomyelitis appears. Timely help from a doctor will prevent this from happening.
Safety
In order to prevent serious complications, the procedure must follow simple rules:
- When injecting the solution for infiltration anesthesia, it is important to remain calm, without making sudden movements and without disturbing the doctor with your hands. This will protect against severe tissue injury.
- To ensure that the injection is not painful, the injection site is pre-treated with an application anesthetic.
- The dentist needs to follow the technique of the procedure.
- To prevent the anesthetic from getting into a large blood vessel, the piston must be pulled towards itself before the introduction of the agent. If blood appears in the syringe, the injection should be repeated, changing the location of the needle.
- To ensure the best effect will allow the introduction of a solution at a rate of 1 ml in 15 seconds.
- If there is no analgesic effect during complex interventions, intrapulpal anesthesia is still required. To do this, 0.2 ml of anesthetic is injected into the pulp chamber.
- When positioning the needle, it should not be pushed far beyond the tip, since the deposition will be performed in the place of the facial muscles, and the tooth will not be anesthetized.
Patients who have been diagnosed with dental phobia should take pills with a sedative effect a day or several hours in advance. With them, it will be possible to reduce severe anxiety and excitement.
