At the end of this lecture, you will be asked if you would like to take this course for continuing education units.
California Continuing Education Credits: 4 units
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| Topical anesthesia is always used prior to injection of local anesthesia. Topical anesthetic ointment, with 20% benzocaine is applied to a cotton roll, placed in the buccal vestibule opposite the surgical area and left in place for 2-3 minutes. | |
| Infiltration anesthesia will be utilized on both the buccal and palatal regions. Two percent lidocaine with 1:100,000 concentration of vasoconstrictor is slowly injected into the buccal mucosa. The needle is slowly advanced and the patients response in monitored so that there is minimal discomfort while the infiltration anesthesia is carried out. | |
| When the buccal infiltration is completed, a few drops of anesthetic solution are injected into each of the interdental papillae. This will give vasoconstriction, and also gives some initial anesthesia on the palatal surface, which will make it more comfortable for the patient when the palatal infiltration anesthesia is carried out. | |
| The palatal infiltration is begun in the areas of vasoconstriction near the interdental papillae. This will reduce the discomfort of the palatal injections. Palatal infiltrations are completed by beginning in the areas of vasoconstriction, and progressively covering the entire area of the palatal surgery. | |
| The pockets that are present are checked with a periodontal probe. A color-coded periodontal probe with 3mm spacing is used. There is evidence of 6mm pockets in the interproximal regions , of the mesial of the molar, | | |
| and 5mm of the distal of the premolar. There are also 5mm pockets that can be probed between the two premolars from the palatal side and a 6mm pocket on the mesial of the first premolar and the distal of the cuspid. There is no abnormal pocket depth on the straight palatal tissue on any of the teeth. | | |
| On the buccal side, the interproximal pockets are present, while the pocket depth on the buccal surfaces are within normal limits. | | |
| Also, there appears to be an adequate with of keratinized tissue along the entire buccal surface, with no significant gingival recession or mucal-gingival problems. | | |
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| The periapical radiograph is used to access the amount of bone loss. There is evidence of interproximal crater formation interdentally between the first molar and premolar. Also, there is angular bone loss between the premolars and on the mesial of the first premolar. We shall now used an organized instrument by instrument approach to this procedure using the UCLA periodontal surgical kit. | |
PERIODONTICS INFORMATION CENTER