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A Prospective, Randomized, Double-Blind Study of the Anesthetic Efficacy of Sodium Bicarbonate Buffered 2% Lidocaine With 1 : 100,000 Epinephrine in Inferior Alveolar Nerve Blocks
Michael Whitcomb DDS, MS,
 Melissa Drum DDS, MS,
 Al Reader DDS, MS,
 John Nusstein DDS, MS, and
 Mike Beck DDS, MA
Article Category: Research Article
Volume/Issue: Volume 57: Issue 2
Online Publication Date: Jan 01, 2010
DOI: 10.2344/0003-3006-57.2.59
Page Range: 59 – 66

The inferior alveolar nerve (IAN) block is the most frequently used injection technique for achieving local anesthesia for mandibular restorative and surgical procedures. However, the IAN block does not always result in successful pulpal anesthesia. 1 – 14 Failure rates of 7–75% have been reported in experimental studies. 1 – 14 Therefore, it would be advantageous to improve the success rate of the IAN block, perhaps by buffering the local anesthetic. Galindo et al 15 used pH-adjusted local anesthetic solutions (pH of 7.4) in

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Local Anesthesia Part 2: Technical Considerations
Kenneth L. Reed DMD,
 Stanley F. Malamed DDS, and
 Andrea M. Fonner DDS
Article Category: Other
Volume/Issue: Volume 59: Issue 3
Online Publication Date: Jan 01, 2012
DOI: 10.2344/0003-3006-59.3.127
Page Range: 127 – 137

offices happen during or immediately following administration of a local anesthetic. 2 An earlier paper by Becker and Reed 3 provided an in-depth review of the pharmacology of these invaluable drugs. In the present paper we will discuss issues of importance to the safe and effective delivery of these drugs, including needle gauge, traditional and alternative injection techniques, and methods to make injections more comfortable for patients (eg, warming, buffering, novel delivery devices). In addition, we will look at the future of local anesthesia in dentistry

Figure 1. ; Posterior superior alveolar (PSA) nerve block.
Kenneth L. Reed,
 Stanley F. Malamed, and
 Andrea M. Fonner
<bold>Figure 1.</bold>
Figure 1.

Posterior superior alveolar (PSA) nerve block.

Figure 2. ; Middle superior alveolar (MSA) nerve block.
Kenneth L. Reed,
 Stanley F. Malamed, and
 Andrea M. Fonner
<bold>Figure 2.</bold>
Figure 2.

Middle superior alveolar (MSA) nerve block.

Figure 3. ; Anterior superior alveolar (ASA) nerve block.
Kenneth L. Reed,
 Stanley F. Malamed, and
 Andrea M. Fonner
<bold>Figure 3.</bold>
Figure 3.

Anterior superior alveolar (ASA) nerve block.

Figure 4. ; Greater palatine (GP) nerve block.
Kenneth L. Reed,
 Stanley F. Malamed, and
 Andrea M. Fonner
<bold>Figure 4.</bold>
Figure 4.

Greater palatine (GP) nerve block.

Figure 5. ; Nasopalatine (NP) nerve block.
Kenneth L. Reed,
 Stanley F. Malamed, and
 Andrea M. Fonner
<bold>Figure 5.</bold>
Figure 5.

Nasopalatine (NP) nerve block.

Figure 6. ; Inferior alveolar (IA) nerve block.
Kenneth L. Reed,
 Stanley F. Malamed, and
 Andrea M. Fonner
<bold>Figure 6.</bold>
Figure 6.

Inferior alveolar (IA) nerve block.

Figure 7. ; The “poke me” line.
Kenneth L. Reed,
 Stanley F. Malamed, and
 Andrea M. Fonner
<bold>Figure 7.</bold>
Figure 7.

The “poke me” line.

Figure 8. ; Second division (V2) nerve block.
Kenneth L. Reed,
 Stanley F. Malamed, and
 Andrea M. Fonner
<bold>Figure 8.</bold>
Figure 8.

Second division (V2) nerve block.