Buffering for other than removing the sting associated with any local injection is a mute point with the advent and approval of 4% Septocaine (Articaine) .... We used to buffer for those few very hard to numb ... now Articaine does the same job.
Our totally painless technic is to start with one of the new topicals .. (Walterberry) ... For the maxillary and mandibular facial apical areas on all but the lower molars .. Inject a drop or two of (warmed) Articaine to start and let it infiltrate ... I have the patient hold light pressure on the cheek or lip over the apical area for about 30 seconds .. I think this helps the infiltration through the bone especially on the lower. .... Then add a few more drops with a little more light pressure and that is all there is to it!
Nothing new about infiltration or periodontal ligament anesthesia here except that we can now anesthetize all the mandibular teeth individually without a full block including the cuspids ... We still use the ligamaject on the mandibular 2nd molars ... mesial and distal lingual or facial corners (depending on the side) near the CE junction into the periodontal space area .... We get complete anesthesia over 99% of the time without a block with these two technics and it's onset is much faster and wears off sooner than the full block, but there is enough time for us to also do crowns there this way. We also give the patients a days worth of an antibiotic on the ligamajects to help prevent any local gingival infections from the ligamaject technique.
On the mandibular 2nd molars, I have found that the periodontal space infiltration works better than the deep lingual ligamaject pressured infiltration thru the bone that some give, and is also much easier and virtually painless to give in comparison.
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