Proper needle landmark for the AMSA injection

Where is the proper needle landmark for the AMSA injection? The injection site for the AMSA is at a point which bisects the first and second pre-molars and is midway between the free gingival margin and mid-palatine suture. This landmark may vary somewhat depending...

Patient experiences tissue sloughing or reaction

Is there anything I should do if my patient experiences tissue sloughing or adverse tissue reaction from an intraligamentary injection? One can provide palative treatment and may recommend a topical ointment to assist in the soft tissue healing. Such ointments...

PDL injection – no anesthetic leaking and no blanching

In doing a PDL injection, everything feels and looks right. No anesthetic is leaking into the patient’s mouth. However, there is no blanching, and when I remove the needle from the patient’s tissue a lot of anesthetic flows into the patient’s mouth....

Blanching but don’t get any pulpal anesthesia

I’ve administered the local anesthetic, and I see blanching, but I don’t get any pulpal anesthesia. Why? What is likely happening is the needle is impinging on the crest of bone. The anesthetic is diffusing into the buccal soft tissue which is why you are...

Overpressure alert and unit stops

I placed the needle into the PDL space as instructed and I keep getting an “OVERPRESSURE” alert and the unit stops, what is the reason for this? You may have blocked the orifice of the needle by pushing to heavily on the hand-piece or by placing the bevel...
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