Articaine ID Blocks and the Crestal Intraosseous Approach for Local Anaesthetic - PDP143

Summary

In this dental-focused podcast, Dr. Jaz Gulati and Dr. Wayne Williams delve into contemporary anesthesia techniques, discussing the merits and safety of inferior alveolar nerve blocks versus buccal infiltrations with articaine. They explore the Crestal Intraosseous Approach, address concerns about nerve damage, and share insights on managing challenging cases like the 'large-headed redhead.' The conversation offers valuable knowledge for dentists seeking to refine their anesthetic practices.

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Q & A

Why has there been a trend among dentists to perform fewer inferior alveolar nerve blocks?

The trend is due to concerns about potential complications such as paraesthesia and other risks associated with inferior alveolar nerve blocks, as discussed in papers and opinion articles, which has led some dentists to be more cautious.

What is an alternative to inferior alveolar nerve blocks that Jaz has been using more frequently?

Jaz has been using articaine infiltrations buccally more often as an alternative to inferior alveolar nerve blocks, finding success with this method and thus reducing the number of nerve blocks performed.

Who is Dr. Wayne Williams and what is his stance on the use of articaine for inferior alveolar nerve blocks?

Dr. Wayne Williams is a prosthodontist who has been a guest on the Protrusive Dental Podcast. He advocates for the use of articaine in inferior alveolar nerve blocks, despite some controversy, and believes in effective anesthesia through this method.

What is the Crestal Intraosseous Approach (CIA) developed by Dr. Wayne Williams?

The Crestal Intraosseous Approach (CIA) is a technique developed by Dr. Wayne Williams that involves injecting anesthetic into the crestal area of the mandible, utilizing the anatomy and 'mystery canals' in the bone to achieve successful anesthesia without drilling into the bone.

What is the 'Robin Hood Dentistry' concept mentioned in the script?

The 'Robin Hood Dentistry' concept refers to the idea of performing careful and well-considered enameloplasty on sharp cusps to create rounded cusps, which can help distribute stress better and create space for restoration of lower molars.

What does the term 'supraperiosteal infiltration' refer to in the context of dental anesthesia?

Supraperiosteal infiltration refers to the injection of anesthetic into the area above the periosteum, with the hope that the medication will penetrate through the bone to reach the nerves of the teeth, as discussed by Dr. Wayne Williams.

Why does Dr. Wayne Williams believe that using a 'wand' for anesthesia is superior to traditional handheld syringes?

Dr. Wayne Williams believes that using a 'wand' for anesthesia is superior because it provides better tactile feedback, allows for automatic aspiration to prevent false negatives, and reduces the pressure and speed of the injection, which can lead to fewer complications such as bruising.

What is the significance of the 'OBAB' course mentioned in the script?

OBAB, which stands for 'Occlusion Basics and Beyond', is a comprehensive course created by Jaz Gulati and Mahmoud Ibrahim to teach dentists about occlusion in a practical and applicable way, aiming to be the best occlusion course in the universe.

What are some of the benefits included in the pre-launch deal for the OBAB course?

The pre-launch deal for the OBAB course includes an OBAB starter kit, a £500 discount on the course, two years of access instead of the standard 12 months, one fully mentored case, and an OBAB book with a visual glossary of occlusion.

What is the controversy surrounding the use of articaine in inferior alveolar nerve blocks?

The controversy lies in the potential risk of paraesthesia and other complications associated with the use of articaine in inferior alveolar nerve blocks. However, Dr. Wayne Williams argues that there is insufficient evidence to directly link articaine to these risks and that the actual cause may be related to the technique and needle used.