Key Points
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Discusses the success rates of conventional local anaesthetic techniques when applied to the acutely inflamed pulp.
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Outlines a staged approach that helps increase success rates of attaining pulpal anaesthesia in the acutely inflamed mandibular molar.
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Discusses key variables (ie solutions, techniques, volume etc) that influence anaesthetic efficacy.
Abstract
Achieving profound pulpal anaesthesia in a mandibular molar diagnosed with irreversible pulpitis can be argued to be the most testing of dental anaesthetic challenges. Following discussion on the possible reasons for this occurrence in part 1, part 2 outlines the various local anaesthetic techniques that practitioners can use to overcome the acutely inflamed mandibular molar. They should then be able to apply these same principles to help anaesthetise any other tooth presenting with an acutely inflamed pulp. Techniques are discussed in detail along with key variables that have been associated with having an impact on the anaesthetic efficacy. This is to bring to light factors that can aid anaesthetic success as well as dispel common misnomers.
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Acknowledgements
I owe sincere and earnest thankfulness to staff members in the Restorative Department of the Leeds Dental Institute for their inspirational guidance and support throughout this project. Furthermore, I am truly indebted and thankful to Mr Collin Sullivan (Clinical Photographer at Leeds Dental Institute) and the Leeds Dental Institute Medical and Dental Illustrative Department for the detailed clinical photographs and illustrations depicted in both parts of this series. Finally, I would like to express my warm thanks to my friends and family who have supported me with their encouraging words.
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Virdee, S., Bhakta, S. & Seymour, D. Effective anaesthesia of the acutely inflamed pulp: part 2. Clinical strategies. Br Dent J 219, 439–445 (2015). https://doi.org/10.1038/sj.bdj.2015.843
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DOI: https://doi.org/10.1038/sj.bdj.2015.843
