Local Anesthetics: I 2011

Objectives and Goals

  • Describe the applied anatomy of the pterygomandibular space as it applies to local anesthesia of the alveolar nerve.
  • Describe the proper administration technique of the inferior alveolar, Gow-Gates, Akinosi, posterior superior alveolar and maxillary second division nerve blocks.
  • Describe the pharmacologic action of common local anesthetics, vasoconstrictors and preservatives and know their indications and contraindications in patient treatment.
  • Recognize and treat adverse reactions to local anesthetics, vasoconstrictors and preservatives.
  • Describe the techniques, physiologic response and postoperative sequelae of intrapulpal, intraseptal and periodontal ligament injections.

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3,4       Watson JE, Colman RS. Interpretation of aspiration tests in local anesthetic injections. J Oral Surg 34:1069-1074. 1976.


4,5       Akinosi JO.  A new approach to the mandibular nerve block.  Brit J Oral Surg  15:83-87


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1,2       *Walton RE, Garnick JJ. The periodontal ligament injection: histologic effects on the periodontium in monkeys. J Endodon 8:22-26. 1982.     


2,3       Chernow B, Balestrieri F, Ferguson CD, Terazhalmy G, Fletcher JR, Lake CR. Local dental anesthesia with epinephrine: minimal effects on the sympathetic nervous system or on hemodynamic variables. Arch Int Med 143:2141-2143. 1983.

3,4       Smith GN, Pashley DH. Periodontal ligament injection: evaluation of systemic effects. Oral Surg 56:571-574. 1983.   

4,5       Smith GN, Walton RE. Periodontal ligament injection: distribution of injected solutions. Oral Surg 55:232-238. 1983.   

5,6       Smith GN, Walton RE, Abbott BJ. Clinical evaluation of periodontal ligament anesthesia using a pressure syringe. JADA 107:953-956. 1983.     

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2,3       Schleder JR, Reader A, Beck M, Meyers WJ. The Periodontal Ligament Injection: A Comparison of 2% Lidocaine, 3% Mepivacaine, and 1:100,000 Epinephrine to 2% Lidocaine with 1:100,000 Epinephrine in Human Mandibular Premolars. J Endodon 14:397-404. 1988.                  


3,4       White JJ, Reader A, Beck M, Meyers WJ. The periodontal ligament injection: a comparison of the efficacy in human maxillary and mandibular teeth. J Endodon 14:508-514. 1988.                       


4,5       Vreeland DL, Reader A, Beck M, Meyers WJ, Weaver J. An evaluation of volumes and             concentrations of lidocaine in human inferior alveolar nerve block. J Endodon 15:6-12. 1989.


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