RU2112460C1 - Method for carrying out local anesthesia of upper incisors, canine teeth and premolars - Google Patents

Abstract

FIELD: medicine. SUBSTANCE: method involves injecting anesthetizing solution at the level of dental plexus end branches location by making injection into vestibular surface of the gingiva 2 mm above circular dental ligament. Needle is moved upward to introduce the needle under the gingiva. 1 ml of anesthetizing solution is injected into this point under pressure. EFFECT: enhanced effectiveness of treatment; multi-purpose application.

Description

 The invention relates to medicine, namely to dentistry, and can be used in the treatment, removal and preparation of teeth for prosthetics.

 Known methods for local anesthesia of teeth and surrounding tissues, which include introducing a solution of anesthetic substance into the area of passage of nerve trunks that carry sensitivity from the corresponding groups of teeth [1]. In this case, the success of anesthesia depends mainly on the accuracy of finding the nerve trunk with an injection needle (ensuring contact of the anesthetic solution with the nerve) and the absence of damage to the adjacent vessel (intravascular injection of the anesthetic solution or a decrease in its concentration with the flowing blood).

 However, when conducting conduction anesthesia in the area of incisors, canines and premolars of the upper jaw, there is a risk of damage to the neurovascular bundle emerging from the infraorbital foramen.

 There is also a method of anesthesia of the upper incisors, canines and premolars, selected as a prototype [2].

 According to the prototype method, anesthesia is performed as follows: the upper lip is raised, an injection is made 0.5 cm above the transitional fold along a vertical line between the central and lateral incisors, the injection needle is directed up, back and out until contact with the front surface of the upper jaw the area of the infraorbital foramen, where the solution of the anesthetic is injected. When anesthetizing the premolar, changing the direction of the needle, its tip is felt on the underlying bone until the infraorbital foramen is found and enter the infraorbital canal to a depth of 0.8 cm.

 To anesthetize the palatine surface of the gums, depending on the location of the tooth, incisor and palatine anesthesia are performed in the usual way.

 The method is dangerous due to the possibility of damage to the neurovascular bundle exiting from the infraorbital foramen, and the associated traumatic neuritis and hematoma. If it is necessary to inject an anesthetic solution directly into the infraorbital canal, an injury to the neurovascular bundle is inevitable.

 A significant drawback of this method of anesthesia is also the complexity of its implementation, due to the fact that the injection needle must be given the direction of an imaginary line to continue the course of the infraorbital canal.

 The invasiveness of this method is significant due to the fact that a considerable array of various tissues have to be pierced from the point of injection of the needle to the infraorbital foramen, and when searching for the infraorbital canal, the periosteum of the upper jaw is injured several times.

 The aim of the invention is to prevent damage to the neurovascular bundle emerging from the infraorbital foramen, simplifying the technique and reducing the morbidity of local anesthesia in the area of the upper incisors, canine and premolar.

 This goal is achieved by the fact that a solution of anesthetic substance is injected into the gum area covering the vestibular surface of the socket of the corresponding tooth.

 The method is as follows.

 The patient is sitting in a dental chair. His head is slightly thrown back. Raise your upper lip with your finger or spatula. An injection is made 1-2 mm above the circular ligament of the tooth on the vestibular surface of the gum, directing the needle with a cut to the bone and up along the longitudinal axis of the tooth. As soon as the lumen of the needle disappears under the gum, its progress is stopped and a solution of anesthetic is injected under pressure. Anesthetic solution under the gum and periosteum of the socket of the corresponding tooth reaches its root and diffuses into the periodontium. When removing a tooth, depending on its location, anesthesia of the incisal or palatine nerve is performed in the usual way.

с целью санации. Произведен укол на вестибулярной стороне десны корня

зуба в точку, лежащую в 2 мм выше круговой связки. Игла направлена снизу вверх вдоль продольной оси корня

зуба. Как только срез иглы скрылся под десной, продвижение ее остановлено и введено под давлением 1 мл 2%-ного раствора новокаина. Дополнительно произведено обезболивание большого небного нерва тем же раствором анестетика в количестве 0,5 мл. Удален корень

зуба. Удаление было безболезненным.Example 1. Patient B-sky V.G., 49 years old, turned to the dental clinic N 1 Donetsk, 05/18/1995, to remove the root

for the purpose of reorganization. An injection was made on the vestibular side of the root gum

tooth to a point lying 2 mm above the circular ligament. The needle is directed from the bottom up along the longitudinal axis of the root

a tooth. As soon as the needle section disappeared under the gum, its advance was stopped and introduced under the pressure of 1 ml of a 2% solution of novocaine. Additionally, anesthesia of the large palatine nerve with the same anesthetic solution in the amount of 0.5 ml was performed. Removed root

a tooth. Removal was painless.

зубов по поводу хронического периодонта. Произведены уколы на вестибулярной стороне десны корней

зубов в точку, лежащую на 2 мм выше круговой связки. Игла направлена снизу вверх вдоль продольной оси корней

зубов. Как только срез иглы скрылся под десной, продвижение ее остановлено и введено под давление по 1 мл 2%-ного раствора новокаина. Дополнительно произведено обезболивание резцового нерва тем же раствором анестетика в количестве 0,2 мл. Удалены корни

зубов. Удаление было безболезненным.Example 2. Patient I-s KP, 58 years old, came on March 22, 1995 to the dental clinic N 1 in Donetsk for root removal

teeth about chronic periodontal disease. Injections were made on the vestibular side of the root gum

teeth to a point lying 2 mm above the circular ligament. The needle is directed from bottom to top along the longitudinal axis of the roots

teeth. As soon as the needle section disappeared under the gum, its progress was stopped and introduced under pressure of 1 ml of a 2% solution of novocaine. Additionally, anesthetization of the incisive nerve with the same anesthetic solution in an amount of 0.2 ml was performed. Roots removed

teeth. Removal was painless.

 The advantages of the proposed method is that it eliminates the possibility of damage to the neurovascular bundle emerging from the infraorbital foramen, and in this regard, the possibility of neuritis and neuralgia, as well as hematomas, which during infection can be a source of severe local processes and intracranial complications .

 The method is extremely simple. Therefore, it can be performed not only by a dental surgeon, but also by a dentist of any profile, and even by a nurse in a dental office.

 The method is less traumatic due to the fact that the depth of advancement of the needle under the gum is determined only by the size of its cut, and further the distribution of the anesthetic solution within the necessary limits is provided by the pressure of the finger on the syringe plunger.

 To achieve anesthesia by the present method requires three to four times less solution of anesthetic substance, and therefore, if it is used on a large scale, we can talk about the economic effect.

 The method of local anesthesia of the upper incisors, canines and premolars can be used in the treatment of teeth, prosthetics of defects of teeth and dentition, as well as tooth extraction.

Sources of information
1. Weissblat S.N. Local anesthesia for operations on the face, jaws and teeth. Kiev: 1962, p. 186-196, 410.

 2. Dubov M.D. Local anesthesia at the dental clinic. M .: 1969, p. 66-69 (prototype).

Claims (1)

 The method of local anesthesia of the upper incisors, canines and premolars, including blocking the conductivity of pain sensitivity from the periodontium of these teeth, characterized in that the anesthetic solution is administered at the location of the final branches of the dental plexus, for which an injection is made into the vestibular surface of the gum 2 mm above the circular tooth ligament , push the needle up until the needle is submerged under the gum and 1 ml of anesthetic solution is injected at this point under pressure.