Manual of Local Anaesthesia in Dentistry Chitre AP
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1 Manual of Local Anaesthesia in DENTISTRY
2 Manual of Local Anaesthesia in DENTISTRY
AP Chitre MDS Hon. Oral and Maxillofacial Surgeon to His Excellency The Governor of Maharashtra Hon. Consultant Oral and Maxillofacial Surgeon Bombay Hospital and Research Centre Professor Emeritus Director of Dental Studies Formerly – Dean and Prof. and Head YMT's Dental College and Hospital Kharghar, New Mumbai — Professor and Head Nair Hospital Dental College Bombay and Examiner University of Bombay — PG Examiner at many universities in India Professor and Chairman Department of Oral Surgery Garyounis University, Ben Ghazi, Libya — Professor and Head Postgraduate teacher Manipal College of Dental Surgery and Examiner Karnataka University — Professor and Head Padmashree Dr DY Patil Dental College and Hospital Navi Mumbai — Professor and Head Postgraduate teacher KLES Institute of Dental Sciences Belgaum and Examiner, Rajiv Gandhi University, Karnataka
Past President of
  1. Association of Oral and Maxillofacial Surgeons of India
  2. Indian Dental Association
  3. Indian Society of Oral Implantologists
3 Published by
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Manual of Local Anaesthesia in Dentistry
© 2006, AP Chitre
All rights reserved. No part of this publication should be reproduced, stored in a retrieval system, or transmitted in any form or by any means: electronic, mechanical, photocopying, recording, or otherwise, without the prior written permission of the author and the publisher.
This book has been published in good faith that the material provided by author is original. Every effort is made to ensure accuracy of material, but the publisher, printer and author will not be held responsible for any inadvertent error(s). In case of any dispute, all legal matters to be settled under Delhi jurisdiction only.
First Edition: 2006
9788180616211
Typeset at JPBMP typesetting unit
Printed at Gopsons Papers Ltd, A-14, Sector 60, Noida 201 301, India
4 Dedicated to my parents
Foreword
It gives me great pleasure to write a foreword on the text ‘ Manual of Local Anaesthesia in Dentistry’. It is a common practice all over the globe to use dentist's name to quieten a child. This was largely due to the painful experiences one often underwent during dental treatment in the past. The advances in the knowledge of pain mechanisms, thorough understanding of pharmacology has resulted in the development of various strategies for pain control particularly in dentistry. Local anaesthesia still remains the most favoured choice of pain control method. It is surprising that in a country like ours, with nearly 200 Dental Schools does not possess a single book on local anaesthesia written by any experienced teacher or a clinician of Indian origin.
Prof. A.P. Chitre, an experienced senior Maxillofacial Surgeon in the Country has undertaken the task of putting down his experiences and scripted this manual of local anaesthesia. It appears, to be a comprehensive book covering all the aspects related to the subject and I am sure, not only the students but all the dentists will find it useful in day to day practice.
I have no hesitation to recommend this book for both undergraduate students and practicing dental professionals. I congratulate Prof. Chitre for this wonderful work, which will benefit the dental profession.
Prof. C. Bhasker Rao
Preface
5 Dental treatment has been associated with pain from time immemorial.
In fact, patients are scared to sit in the Dental Chair and will prefer to suffer until it becomes worse and unbearable.
Dental pain is unique and worst compared to all other pains in the body. In Greek Mythology there is reference to the punishment given to Saint Appolonia who was branded as a witch. It was decreed that her teeth should be removed without anaesthesia only one at a time. Later, however, it was proved that she was not a witch and was granted sainthood.
Performance of painless dental procedures is highly appreciated by the patients and is easily possible with the help of available local anaesthetic solutions and techniques. However, sound knowledge of surgical anatomy comprising of osseous landmarks, position of exit foramina of the 5th cranial nerve, attachment of muscles, innervation of soft and hard tissues is essential. Correct position of the patient and operator while performing the procedure gives successful results.
Detailed, relevant and meticulous history taking will forewarn the operator and will avoid a mishap. Adequate information about the drug used as local anaesthetic agent with relevance to proper dosage, contraindications and possible side reactions will help the Dental Surgeon to be well prepared for the eventualities. Last but not the least gentle tissue handling will avoid many untoward reactions and unpleasant situations.
Sound local anaesthesia is epitome of successful dental practice hence the need for this treatise for Dental students and practitioners.
AP Chitre
Acknowledgements
6The compilation of this book is the result of teamwork. Notable to mention would be my two colleagues: Dr. M.I. Parkar, Assistant Professor in Oral and Maxillofacial Surgery, at YMT's Dental College and Hospital, Kharghar, Navi Mumbai, who prepared and corrected the manuscripts after the basic format was prepared. He also collected the various references and prepared the bibliography for every chapter. The second colleague, Dr. Raj Shekhar Halli, Associate Professor in Oral and Maxillofacial Surgery, at KLES's Institute of Dental Sciences, Belgaum, Karnataka, prepared the various diagrams on computers showing the basic anatomy for various injection techniques. The photographer and the model who spent their time patiently. Last but not the least, the Publishers, M/s Jaypee Brothers Medical Publishers (P) Ltd., and their representative, Mr. C.S. Gawde of Mumbai Branch, who approached me for writing the book and their subsequent cooperation.
I am deeply indebted to Prof. C Bhasker Rao, Dean, SDM Dental College and Hospital, Dharwad, Karnataka; and Vice-President, Dental Council of India, for writing the foreword.
I thank all the concerned people who have made the publication of this book a reality.