After performing the intraligamentary injection my patient experienced
adverse tissue reaction. Why is this so?

The reasons for this are as follows:

Adverse tissue reactions can result from either mechanical damage to the
tissues or excessive volumes of anesthetic solution being improperly placed
within the soft tissues. This may lead to a blockage of blood flow to these
tissues culminating in adverse tissue reaction. It is also quite possible that
certain patients with a thin delicate periodontium may be more prone to
adverse tissue reaction due to the anatomic variations of these patients.

Mechanical trauma can play a role in adverse tissue reaction. You
can prevent mechanical trauma by using delicate, careful needle placement
within the POL. If one notices a very rapid and extreme blanching of the interdental
papilla when performing the POL injection one is advised to verify correct
needle position. This type of extreme response can be related to improper
needle placement or proper placement of the needle on a patient with a
thin, delicate tissue type. Either of these conditions may lead to an excessive
build up of fluid volume within the soft tissues for that patient.

It is also advisable to assess the tissue quality of a patient’s periodontium
prior to performing an intraligamentary injection. Patients with th in, delicate
periodontal tissues may be more prone to adverse tissue reaction when performing
the POL injection, particularly if large volumes of solution are placed
into the overlying soft tissues.

Finally, it is important to adhere to the anesthetic recommendations from the
drug manufacturer when performing the intraligamentary injection.

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