For many dental problems, anesthesia is used. Its type is selected based on the type of procedure. Often used infiltration anesthesia, which provides effective analgesia. Its features and types are described in the article.
What it is?
Infiltration anesthesia is a type of anesthesia used in dentistry in the treatment of teeth and other parts of the oral cavity. With it, the nerve endings of the operated site are blocked by entering an anesthetic. The drug can be administered in different parts of the oral cavity, it all depends on the goals.
Based on the injection area, infiltration anesthesia is direct and indirect, which, compared with the first type, anesthetizes the dental plexus. The direct method is intended for procedures on the processes of the alveolar ridge or soft tissues. An indirect method is used for tooth extraction and surgery on the jaw bone.
In both cases, anesthesia blocks nerve endings for several minutes. The difference lies in the means of delivery and the place of exposure. The drug introduced under the mucosa or periosteum is delivered to the vascular bundle. An anesthetic implanted in 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, the drug will act quickly and effectively.
For the lower jaw
In this situation, anesthesia is used only for short manipulations on soft tissues. If serious intervention is necessary, it is combined with other types of anesthesia, which enhances the effect. This approach is associated with the structure of the jaw. Alveolar tissues of the lower jaw are dense and porous, so the pain medication completely penetrates the nerve bundle.
A less dense part is considered to be the anterior section, where there are many micropores, so this anesthesia is used when manipulating incisors. Stopping the pain will allow the introduction of the drug into the transitional fold. To anesthetize all incisors, an injection is made in the crease between the first incisors. Then the solution is fed by moving the needle towards the canine.
On the upper jaw
Infiltration anesthesia is actively used in the treatment 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 are 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 pain from the sky, it is necessary to chop off the mucous membrane at the site of the incisor opening. So anesthesia of the first premolar is performed. To anesthetize the nerve fibers of the molars, the second premolar needle is pierced between the tooth and the adjacent premolar. You also need to chop off the top of the corner from the alveolar and palatine processes.
Intraligamental
This is a type of infiltration anesthesia in dentistry, in which the solution is injected into the ligaments of the tooth. The product is injected under high pressure, so it definitely gets into the bone of the alveolar ridge. This method has excellent efficiency and is used for serious dental procedures.
Intraventricular
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 completely block the nerve endings of the tooth, so an injection from the palatine part is required.
Subperiosteal
For this procedure, you need a syringe with a short needle, 3 cm long. It must be placed between the base of the root and the gum, choosing the transition point of the moving portion of the mucosa to the stationary.
The drug is administered with a sharp pressure on the piston. For this manipulation, a minimum of anesthetic is required, while absolute nerve block is performed in a short time.
According to Vishnevsky
Vishnevsky infiltration anesthesia is special, with it anesthetic enters the tissue in layers. Anesthesia of each layer occurs separately due to the "creeping infiltrate". This action is provided by the introduction of a solution under pressure. The product is distributed throughout the tissues, therefore, contact with the nerves of the operated area is ensured.
Indications and contraindications
Local infiltration anesthesia can be used for:
- autopsy of purulent abscesses;
- treatment of the shell of the oral cavity;
- mandibular anesthesia;
- removal of temporary teeth on two jaws;
- removal or treatment of permanent teeth in the upper jaw;
- suturing of the mucosa during injury.
This type of procedure should not be used for intolerance to drugs. In this case, the specialist will choose the most effective method of pain relief.
Advantages and disadvantages
This anesthesia is known for several advantages compared with other methods of pain relief:
- A simple technique, since it is not necessary to strictly follow the anatomical orientation.
- There is a quick stopping of nerve fibers of a painful tooth and adjacent tissues.
- You can use a minimum concentration of the product, making this method safe.
Because of these advantages, the procedure is effective. In addition to the advantages, the technique has disadvantages:
- A small area of pain relief.
- Restriction for use on the lower jaw.
- Short term anesthesia.
Execution Rules
The technique of infiltration anesthesia is uniform, no matter what area it is injected into. The procedure is as follows:
- Aseptic processing of the mucosa is carried out at the proposed injection site.
- After that, the dentist becomes to the right of the patient.
- With a finger or a mirror, the doctor pushes his lip or cheek so that the rolling fold becomes exposed.
- The needle tip must be installed on the transition fold at an angle of 45 degrees to the alveolar ridge. Its section is turned to the jaw bone.
- It is required to insert a needle into the tissue. It should be placed on 5-15 mm, it all depends on the injection site.
- Then the drug is administered.
This is the basis for conducting 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 unpleasant sensations should arise.
In children
When treating teeth in children, psycho-emotional overstrain usually occurs. It will not work to force them to endure pain, therefore 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 peculiarities of the blood supply to the oral cavity, children often have toxic effects from anesthetics, which parents usually associate with allergies. Since such reactions are considered contraindications, it is necessary to tell the dentist about the manifestation of side effects.
If the children refuse to treat their teeth and go to the dentist, arrange a tantrum, anesthesia is often prescribed. But before agreeing to this procedure, which has a list of contraindications, you must consult another doctor. Children should have contact with a dentist and trust in him, and then the treatment will be successful.
Preparations
The most effective drugs include articaine preparations:
- "Ubistezin." It contains a vasoconstrictor component that provides a long and stable anesthetic effect.
- Ultracaine. It is released with and without epinephrine. The drug can not be used for diabetes, hypertension, asthma.
- "Septanest". Includes epinephrine and preservatives that are absent in Ubistesin and Ultracaine.
- "Orablok". The tool is similar to "Ubistezin."
Lidocaine and novocaine are not used in infiltration anesthesia. These drugs are toxic compared to anesthetics with articaine. Novocain is powerless with purulent inflammation.
Probable complications
A post-injection complication is soreness in the injection area. It occurs when the needle is inserted incorrectly into the mucosa. If there is no appropriate aseptic treatment, soft tissue inflammation 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 assistance due to inflammation, peeling of the mucous membrane and periosteum appears, and this can cause soft tissue necrosis. Due to the purulent process, infection of the jaw bone occurs and osteomyelitis appears. Timely help from a doctor will prevent this.
Security
In order to prevent serious complications, during the procedure you need to follow simple rules:
- When injecting a solution for infiltration anesthesia, it is important to remain calm without making sudden movements and without interfering with the doctor's hands. This will protect against severe tissue injury.
- So that the injection is not painful, the injection site is pre-treated with an application anesthetic.
- The dentist must follow the procedure.
- In order to exclude the anesthetic from entering a large blood vessel, the piston must be pulled over before administering the drug. If blood appears in the syringe, the injection should be repeated, changing the location of the needle.
- Provide the best effect will allow the introduction of the solution at a speed of 1 ml in 15 seconds.
- If there is no analgesic effect during complex interventions, intrapulpral anesthesia is still required. To do this, 0.2 ml of anesthetic is injected into the pulp chamber.
- When positioning the needle, you should not push it far beyond the tip, since the deposition will be performed in the place of the muscles of the face, without having anesthetized the tooth.
Patients with dentophobia should take pills with a sedative effect in a day or several hours. With them, it will be possible to reduce severe anxiety and excitement.