BDS III - 2025 Injection Techniques
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What is the primary indication for performing a Middle Superior Alveolar (MSA) nerve infiltration?

  • When a patient experiences severe pain in the maxillary molars
  • Dental procedures involving both maxillary premolars only (correct)
  • When the upper incisors require anesthetic coverage
  • When infra-orbital nerve block fails to provide pulpal anesthesia distal to the maxillary canine (correct)

    • A 27-gauge short needle is more likely to be available and is perfectly acceptable for MSA nerve infiltration.

    True (A)

    Where is the target area for the MSA nerve infiltration?

    Maxillary bone above the apex of the maxillary second premolar.

    The Anterior Superior Alveolar nerve infiltration provides anesthesia to the maxillary _____, lateral incisor, central incisor, alveolar bone, and buccal gingiva.

    <p>canine</p> Signup and view all the answers

    Match the following landmarks with their corresponding dental procedures:

    <p>Maxillary bone above the apex of the maxillary second premolar = MSA nerve infiltration Mucobuccal fold in the area of the central/lateral incisor and canine = Anterior Superior Alveolar Nerve infiltration Height of the mucobuccal folds above the maxillary second premolar = MSA nerve infiltration Buccal periodontal tissues and bone over the maxillary first and second premolars = MSA nerve infiltration</p> Signup and view all the answers

    Which of the following techniques is used for providing mandibular anaesthesia?

    <p>Inferior Alveolar Nerve Block (D)</p> Signup and view all the answers

    Infiltration techniques work effectively in the posterior segments of the mandible.

    <p>False (B)</p> Signup and view all the answers

    What is anaesthetized by the Inferior Alveolar Nerve Block?

    <p>8 mandibular teeth of that quadrant including the bone, buccal soft tissue anterior to the mental foramen, the anterior 2/3 of the tongue, and the floor of mouth.</p> Signup and view all the answers

    The __________ technique is used for maxillary anaesthesia via the Greater Palatine nerve.

    <p>Block</p> Signup and view all the answers

    Match the injection techniques with their corresponding nerves:

    <p>Inferior Alveolar Nerve Block = Mandibular anaesthesia Greater Palatine Nerve Block = Maxillary anaesthesia Mental Nerve Block = Buccal soft tissue anaesthesia Long Buccal Nerve Block = Soft tissue anaesthesia of the buccal area</p> Signup and view all the answers

    What is the role of citric acid monohydrate in a formulation?

    <p>It acts as a preservative. (A)</p> Signup and view all the answers

    Hydrochloric acid is used primarily to enhance flavor.

    <p>False (B)</p> Signup and view all the answers

    What is one contraindication for using local anesthetics of the amide type?

    <p>Hypersensitivity to local anesthetics</p> Signup and view all the answers

    ________ is used to prevent infection at the site of injection.

    <p>Silicone</p> Signup and view all the answers

    Match the substance to its function:

    <p>Citric acid monohydrate = Maintains stability of active ingredients Hydrochloric acid = Maintains the pH Sodium hydroxide = Reduces oxidation of vasoconstrictor Silicone = Prevents infection at injection site</p> Signup and view all the answers

    What is the purpose of adrenaline in the local anaesthetic solution?

    <p>To prolong the duration of action and reduce bleeding (C)</p> Signup and view all the answers

    Sodium metabisulphite is used to increase blood flow to the injection site.

    <p>False (B)</p> Signup and view all the answers

    What is the penetration depth of the needle tip during the injection?

    <p>10mm</p> Signup and view all the answers

    The active ingredient in Xylotox-E80A that produces local anaesthesia is __________.

    <p>Lidocaine hydrochloride</p> Signup and view all the answers

    Which of the following is NOT a part of the universal protocol for local anaesthesia?

    <p>Injecting the solution quickly (B)</p> Signup and view all the answers

    Match the following constituents to their functions:

    <p>Lidocaine HCl = Produces local anaesthesia Adrenaline = Prolongs duration of action and decreases bleeding Sodium metabisulphite = Prevents oxidation of vasoconstrictor General anaesthetic = Induces unconsciousness</p> Signup and view all the answers

    What area is anaesthetised during a mental nerve block?

    <p>Buccal mucosa, lower lip, chin (A)</p> Signup and view all the answers

    The bevel of the needle for the mental nerve block should be directed away from the bone.

    <p>False (B)</p> Signup and view all the answers

    What percentage of lidocaine hydrochloride is found in Xylotox-E80A?

    <p>2%</p> Signup and view all the answers

    What is the recommended needle gauge for loading the syringe for infiltration?

    <p>27G or 30G</p> Signup and view all the answers

    Proper patient __________ is essential during local anaesthetic administration.

    <p>positioning</p> Signup and view all the answers

    The injection site for the mandibular block is located distal and buccal to the most distal molar in the arch on the anterior border of the _______.

    <p>ramus</p> Signup and view all the answers

    Which step involves using a mirror to retract the mucosa?

    <p>Step 4 (D)</p> Signup and view all the answers

    Match the following steps to their corresponding procedure.

    <p>Load syringe with needle = Step 1 for both Ask patient to open mouth = Step 3 for both Apply topical anaesthetic = Step 5 for both Insert needle = Step 6 for mental nerve block</p> Signup and view all the answers

    The operator should stand directly in front of the patient when administering injections.

    <p>True (A)</p> Signup and view all the answers

    When aspirating, if the result is ________, the solution can be deposited.

    <p>negative</p> Signup and view all the answers

    What is the recommended needle size for lingual infiltration?

    <p>30G short needles (C)</p> Signup and view all the answers

    The operator should always stand to the right of the patient during a lingual infiltration.

    <p>False (B)</p> Signup and view all the answers

    What angle should the back of the chair be tilted to during lingual infiltration?

    <p>45 degrees</p> Signup and view all the answers

    The injection of LA into palatal tissue is considered the most uncomfortable of intra-oral injections, especially during ______.

    <p>palatal surgery</p> Signup and view all the answers

    Which of the following indicates a greater palatine nerve block?

    <p>Maxillary teeth extractions (D)</p> Signup and view all the answers

    Where is the greater palatine foramen located?

    <p>lateral aspect of the hard palate, opposite the second or third molar</p> Signup and view all the answers

    Match the following steps for performing a greater palatine nerve block with the correct actions:

    <p>Step 1 = Load the syringe with an ampoule and appropriate needle Step 3 = Ask the patient to open the mouth Step 5 = Locate the greater palatine foramen Step 6 = Apply pressure with a cotton swab to the hard palate</p> Signup and view all the answers

    The local anaesthetic solution should be administered at a volume of ______ during the lingual infiltration.

    <p>0.5ml</p> Signup and view all the answers

    Flashcards

    Inferior Alveolar Nerve Block

    A block technique providing anaesthesia to mandibular teeth and soft tissues.

    Long Buccal Nerve

    Nerve supplying buccal soft tissue anterior to the mental foramen.

    Maxillary Anaesthesia

    Local anaesthesia techniques used for maxillary arch procedures.

    Mandibular Infiltration Techniques

    Less effective due to dense bone in the posterior mandible.

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    Criteria for Needle Insertion

    Height of injection, antero-posterior position, and another metric.

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    Injection Site

    Location distal and buccal to the most distal molar in the arch.

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    Topical Anaesthetic Application

    Using a topical agent to numb the treatment area before injection.

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    Needle Insertion Depth

    Insert the needle 1-3mm with tissue taut and the bevel towards the bone.

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    Aspirate Technique

    Pull back on the syringe to check for blood before injecting.

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    Mental Nerve Block Area

    Anaesthetises buccal mucosa, lower lip, incisors, canines, premolars, and chin.

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    Indications for Nerve Block

    Used for pulpal anaesthesia anterior to mental foramen or when IAN block is not indicated.

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    Needle Angle for Insertion

    Direction of the needle is parallel to the long axis of the tooth at a 45-degree angle to the buccal plate.

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    Injection Speed

    Deposit 0.5ml of solution over 10 seconds for effective anaesthesia.

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    Citric Acid Monohydrate

    A preservative that maintains stability of active ingredients and controls pH.

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    Hydrochloric Acid

    A buffer that maintains pH and reduces oxidation of vasoconstrictors.

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    Sodium Hydroxide

    A buffer used to maintain pH and reduce oxidation of vasoconstrictors.

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    Silicone Antiseptic

    Prevents infection at the injection site.

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    Contraindications

    Conditions preventing use of certain local anesthetics, including hypersensitivity and specific health issues.

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    Needle Tip Placement

    Needle tip is under mucosa by the alveolar bone apex.

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    Injection Depth

    Penetration depth of the needle is approximately 10mm.

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    Injection Technique

    Inject ⅔ of the solution over 45 seconds at the site.

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    Needle Recapping

    Withdraw the needle and safely recap it after injection.

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    Warming Local Anaesthetic

    Warm local anaesthetic solution to near body temperature.

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    Active Ingredients in Xylotox-E80A

    Contains Lidocaine, Adrenaline, and Sodium metabisulphite.

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    Functions of Lidocaine and Adrenaline

    Lidocaine provides anaesthesia; Adrenaline prolongs its effect.

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    MSA Nerve Infiltration Indication

    Used when infra-orbital nerve block fails for maxillary canine pulpal anesthesia.

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    Anaesthetised Area for MSA

    Pulp of maxillary first/second premolars and mesio-buccal root of the first molar.

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    Needle Gauge for MSA

    Recommended 25-gauge short/long; 27-gauge short is acceptable.

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    Insertion Height for MSA

    Height of mucobuccal folds above the maxillary second premolar.

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    Target Area for MSA

    Maxillary bone above the apex of the second premolar.

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    Positioning for MSA Infiltration

    Right MSA: 10 o'clock; Left MSA for right-handed: 8/9 o'clock.

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    Anterior Superior Alveolar Indications

    Indicated for dental extractions, minor oral surgery, root planing.

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    Infiltration Area for ASA

    Anesthesia to maxillary canine, lateral incisor, central incisor, alveolar bone, and buccal gingiva.

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    Lingual infiltration

    An anesthesia technique targeting the terminal branches of the lingual nerve.

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    Needle size for lingual infiltration

    Recommended use of 30G short needles for the procedure.

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    Operator position during injection

    The operator should stand in front of the patient, to the right or right rear position.

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    Point of needle insertion

    Insert needle parallel to the tooth's axis at the muco-lingual fold, 3-5mm cervical to the free gingival margin.

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    Greater Palatine Nerve Block

    An injection aimed at numbing the palatal tissue, often seen as uncomfortable.

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    Patient position for palatine block

    Seat the patient in a semi-fowler's position at a 30° angle during the block.

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    Finding greater palatine foramen

    Locate it on the hard palate, opposite the second or third molar for effective anesthesia.

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    Study Notes

    BDS III - 2025 Injection Techniques

    • Course offered by the Department of Maxillo-facial and Oral Surgery
    • Designed for third-year dental students (BDS III) in 2025
    • Covers injection techniques for mandibular and maxillary anaesthesia

    Mandibular Anaesthesia: Block Technique

    • Nerves targeted: Inferior Alveolar Nerve, Long Buccal Nerve, Mental Nerve
    • Infiltration Techniques: Incisive nerve, Lingual nerve, Mental nerve, Long Buccal Nerve

    Maxillary Anaesthesia: Block Technique

    • Nerves targeted: Greater Palatine nerve/ Nasopalatine nerve, Anterior / Middle and Posterior Superior Alveolar Nerve/ Greater Palatine nerve/ Nasopalatine nerve
    • Local Infiltrations: Covered

    Nerve Supply of Oral Structures

    • Table 13.2 details the nerve supply for maxillary teeth and periodontal tissues.
    • Includes teeth like central incisor, lateral incisors and canines, premolars, first molars, second and third molars.
    • Details the specific nerves supplying each tooth and associated soft tissues (buccal and palatal).

    Injection Techniques for Dental Procedures: Mandibular Anaesthesia

    • Problem: Infiltration techniques are less effective in the posterior segments of the adult mandible
    • Solution: Block technique is used
    • Areas anaesthetized: 8 mandibular teeth per quadrant, buccal soft tissue anterior to the mental foramen, anterior 2/3 of the tongue, lingual soft tissue and periosteum

    Injection Techniques for Dental Procedures: Steps for Inferior Alveolar Nerve Block

    • Positioning: Patient seated upright, head tilted backward. The operator stands in front of the patient. Left IANB requires repositioning the operator.
    • Identifying Landmarks: External oblique ridge, pterygomandibular raphe, coronoid notch.
    • Injection Technique: Needle placement and insertion details are provided through a series of steps.

    Injection Techniques for Dental Procedures: Steps for Long Buccal Nerve Block

    • Positioning: Direct techniques are provided for the patient and operator positioning.
    • Identifying Landmarks: Distal molar, anterior border of ramus, buccal soft tissue.
    • Injection Technique: Needle placement and insertion through a series of steps are described

    Injection Techniques for Dental Procedures: Steps for Mental Nerve Block

    • Area Anaesthetised: buccal mucosa, lower lip, pulp of the incisors, canines and premolar teeth.
    • Indications: For pulpal anesthesia to teeth anterior to mental foramen. Used when inferior alveolar nerve block isn't indicated.

    Injection Techniques for Dental Procedures: for Lingual Infiltration

    • Area Anaesthetised: Terminal branches of the lingual nerve.
    • Injection Technique: Positioning, identifying landmarks (floor of mouth, muco-lingual fold), needle insertion, and injection details given in steps.

    Injection Techniques: Greater Palatine Nerve Block

    • Infiltration Procedure: The injection site is palatal, distal to the most distal molar and the anterior border of the ramus.
    • Indications: Maxillary teeth extractions, gingival retraction, palatal surgery, and subgingival scaling

    Injection Techniques: Posterior Superior Alveolar Nerve Infiltration

    • Indications: Pulpal anaesthesia of maxillary teeth, buccal gingival soft tissue anaesthesia of the corresponding alveolar bone related to maxillary molars
    • Steps: Position patient, inject topical anesthetic, locate insertion area for needle using landmarks, insert needle, inject solution, withdraw.

    Injection Techniques: Middle Superior Alveolar Nerve Infiltration

    • Area Anaesthetized: Maxillary first and second premolars, and mesio-buccal roots, buccal periodontal tissue, and bone over these teeth.
    • Indications: Used when infra-orbital nerve block fails, procedures involving maxillary premolars only
    • Procedure: Detailed steps are provided on positioning, target location, inserting the needle, and injecting the local anesthesia.

    Injection Techniques: Anterior Superior Alveolar Nerve Infiltration

    • Area Anaesthetized: maxillary canine, lateral incisor, central incisor, alveolar bone, buccal gingiva
    • Indications: For dental extractions, minor oral surgery, and root planning.
    • Procedure: Detailed steps on positioning and needle insertion location to target alveolar bone are provided

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    BDS III 2025 Injection Techniques PDF

    Description

    This quiz focuses on injection techniques relevant to third-year dental students (BDS III) in 2025. It covers both mandibular and maxillary anaesthesia, including the targeted nerves and infiltration techniques used in oral surgery. Test your knowledge and understanding of these essential procedures.

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