Sedation Dentistry


Topical drugs are drugs that break the spread of neural networks in a repeatable manner when they are placed in contact with nerve fibers and at an estimated concentration. Neural tube cutting affects the sensory, motor, and cordial nerve fibers. The friendly cochine was the first topical drug discovered in 1860 when Niemann isolated it from coca leaves In the form of alkali and then introduced as a local anesthetic in 1884 by Koller and Freud during the first half of the twentieth century many of the derivatives were installed starting with cocaine.

- In 1905 Procaine was synthesized by Einhorn, but Lidocaine was only synthesized in 1943 by Lofgren. This latter drug is an excellent localized effect and has no significant toxicity. Amide is derived from the acid Diethyl Aminoacide

Since then, the new topical drugs that have been installed and used clinically have been from the Amid group except Chloroprocaine

- Knowledge of the physiology of neurotransmitters is compulsory to understand all the mechanisms of the local drug act.

Local drug effect mechanisms:

Local anesthesia methods

Local anesthesia injection

Local topical anesthesia

C) local anesthesia spray (aerosol)

D - local anesthesia cryoanesthesia

Methods and mechanism of local anesthesia injection

1 - supraperiosteal injection technique

2 - subperiosteal injection method

3-sub-mucosal injection

4 - anesthesia in the gum interdental papilla injection

5. Periodontal ligament injection

6. Intravenous injection of bone

7. Intrapulpal injection

8. Anesthesia within the intrataseptal injection

9. Anesthesia of the six upper incisors

10. Anesthetization of the six lower incisors

- Anesthesia in the bone intraosseous injection

By injection into the bone after a hole inside the bone by a perforator (such as a van den berg) or a small surgical spike after an injection (an injection of soft tissue anesthesia)

- The needle is pushed directly into the bone and must be short, thick and resistant.

- It is not preferable to use this method because of the pain and the resulting disease and because of the progress of the local anesthesia and topical drugs, and it is also an antidote to the presence of other fungal infections

Anesthesia within the intrataseptal injection

- It is similar to the syringe of the ligament and is used to anesthetize the bone and soft tissues and is used especially in the operations of gingival gum, rheumatic pockets and gingival segments

- It is a good thing that it provides good veins for bleeding in the injected area

- A short needle is used and injections at the base of the papillary papilla vertically on the gums, so that the syringe is made angle 45 with the longitudinal axis of the tooth

- injections during the entry of the needle until it collides with the alveolar bone within 1-2 mm and inject 0.2-0.4 mm

- Have the same disadvantages and complications of the syringe.

Local topical anesthesia

- Substance is in the form of liquid, ointment, gel, disinfectant, eye drops, suppositories or vaginal eggs for the same purposes.

- Apply a piece of cotton or paper to the place of anesthesia or touch the finger to remove the sense of pain in the area of ​​the mucosa and sometimes the skin.

- These ointments are useful in cases of castles and reflex of vomiting and in cases of tooth eruption.