The Closed mandibular nerve block 💉

❇️ The Vazirani-Akinosi technique:

🔆“It is a specific method of nerve block in the mandibular region, carried out with the mouth closed.

❇️ The area of distribution of the anaesthesia includes

a) the corresponding dental arch,

b) the body of the jaw and the inferior ramus,

c) the gingiva/mucosa and vestibular periosteum, anterior to the mental foramen

d) the area of distribution of the lingual nerve: 2/3 of the anterior of the tongue and floor of the mouth, the gingiva/ mucosa and lingual periosteum.

🔆» The main indication, already anticipated, is trismus: classically this is contraction of the masticatory musculature which prevents the performance of effective inferior alveolar anaesthesia, for example, in cases of pulpitis or an abscess of a lower molar.

– By Dr. Sneha poeghal , Mallareddy institute of dental sciences , hyd .

References – Malamed

The surgical blades

❇️Disposable surgical blades –

💠There are many forms of blades available,regardless, you need to make sure that you have a good access and the blades are sharp before you make any incision .

💠*Blade no. 12 and no.12D are particularly useful at distal incision where you have difficult access, for example distal wedge surgery.

💠Blade no.15c is used in periodontal surgeries as it has an extended cutting edge .

💠Change the blade if it is blunt or you may risk tearing the tissue on flap elevation or creating a jagged incision line.

– by Dr.Sneha poeghal

Reference books – Carranza

Frnectomy

❇️ Frenectomy: The frenum is a normal anatomical structure of the oral cavity but the position of its attachment may characterize it as abnormal, warranting removal.

❇️Clinical findings associated with an aberrant frenum include:

  • midline diastema
  • gingival recession
  • inadequate attached gingiva
  • shallow vestibule

💠Here are some common incision designs used for frenectomy via excision with a scalpel.

✳️ Diamond: This conventional incision design involves a diamond shaped excision of the frenum with blunt dissection to relieve the attachment. The margins of the surgical site are reapproximated in a linear fashion.

✳️ZPlasty: This technique is commonly used for scar removal in plastic surgery. It is indicated for a thick frenum with low insertion. An elliptical excision of the frenum is performed, followed by the creation of two triangular flaps (~60 degree angle) with a “Z” shaped incision, which are transposed to reorient the tissue and achieve primary closure.

✳️VY-Plasty: This V-shaped incision is highly useful for a broad frenum attachment. In this case, the superior margin of the wound is repositioned apically and sutured in a “Y” shape.

– by Dr.Sneha poeghal (BDS) from Mallareddy institute of dental sciences.👩‍⚕️

Reference books- carranza

The black fungus

❇️We have been hearing some terrible stories of Black Fungus and how it is spreading and causing an epidemic. This is scary. This has to be stopped and it can only be done by self care.

❇️The cause for the development of black fungus is largely attributed to the unhygienic usage of masks, yes you read that right. Each person has bacteria and virus within themselves that don’t cause any harm. There is enough evidence that the Covid recovered patients when use unhygienic masks, let the bacteria develop and grow into a fungus when it meets moisture in the mask. This gets inhaled again and thus becomes fatal.

🦷What are categorized as unhygienic masks: 1. Reusage of one time use masks 2. Sharing masks

❇️Let’s wake up now before things get worse. Let’s follow these simple steps to contain the epidemic in its initial phase.

  1. Reusable masks to be washed and sun dried after each use
  2. One time use masks to be disposed in a safe way
  3. Stop sharing masks
  4. Avoid prolonged usage of masks by reaching home as soon as you can or taking a fresh breather when it’s safe to do so.

– by Dr. Sneha poeghal BDS from Malla Reddy institute of dental sciences ,hyd.