Dental Medications and Radiography Techniques

Posted on Mar 31, 2025 in Biology

Key Medications in Dentistry

Local Anesthesia

  • Ester Family: Example: Procaine. Lower usage due to potential for allergic reactions.
  • Amide Family: Examples: Lidocaine, Mepivacaine. Generally considered safer.

Anesthetic Techniques

  • Infiltrative Technique: Used for periapical areas of mandibular and maxillary anterior teeth. Anesthetizes nerve endings in a specific territory.
  • Maxillary Anesthesia (Surgical/Endodontic): Targets only the pulp of the tooth (periapical infiltration).
  • Maxillary Anesthesia (Periodontal/Extractions): Anesthetizes pulp, gingiva, and palate; requires additional anesthetic infiltration in the palatal mucosa.
  • Truncal (Nerve Block) Technique: Example: Inferior alveolar nerve block. Anesthetizes the entire territory supplied by a single nerve.
  • Mandibular Anesthesia (Operative/Endodontics): Typically involves a nerve block of the mandibular nerve.
  • Mandibular Anesthesia (Periodontal/Extractions): Requires anesthesia of the mandibular nerve, plus the buccal and lingual gingiva.

Analgesics (Pain Relief)

  • Opioid Analgesics: Mimic the body’s natural endorphins. Examples: Morphine, Codeine, Tramadol.
  • NSAIDs (Non-Steroidal Anti-Inflammatory Drugs): Reduce inflammation by decreasing prostaglandins. Examples: Ibuprofen, Aspirin, Paracetamol (often grouped with NSAIDs), Diclofenac, Piroxicam, Ketoprofen.

Corticosteroids

Possess immunosuppressive and anti-inflammatory properties. Examples: Triamcinolone, Prednisone.

Antibiotics

  • Penicillin Family: Amoxicillin is common, sometimes combined with Clavulanic Acid to overcome resistance.
  • Macrolide Family: Used for patients allergic to penicillin.
  • Metronidazole: Used in specific cases, such as certain types of periodontitis.

Antifungals

  • Nystatin: Typically available as an oral rinse.
  • Fluconazole: Typically available in tablet form.

Anxiolytics (Anti-Anxiety)

Used to manage dental anxiety. Examples: Diazepam, Bromazepam, Clorazepate, Lormetazepam.

Mouthwashes

  • Antiseptics: Examples: Chlorhexidine, Hexetidine, Triclosan.
  • Other Functions: Antiplaque agents, reinforcement of oral tissues (e.g., fluoride, vitamins for gums), agents for dental hypersensitivity (e.g., potassium nitrate).

Dental Radiography (X-rays)

Film Development Process

  1. Developing: After exposure, silver bromide crystals on the X-ray film are excited by the received energy. When the film contacts the alkaline developer liquid, silver separates from the emulsion and precipitates onto the film base, causing darkening. Areas with less excitation (less radiation) precipitate less, resulting in shades of gray. Developing typically takes about 1 minute.
  2. Washing: A crucial step to remove the developer solution, lasting about 20 seconds.
  3. Fixing: The fixer solution removes unexposed, unprecipitated silver bromide crystals from the emulsion and stabilizes the image. This step takes at least 3 minutes, ideally around 10 minutes.
  4. Final Wash and Drying: The fixing solution is removed with water, and the film is dried thoroughly for several minutes.

Note: Increased time and temperature during development lead to more precipitation (darker image). Larger silver bromide crystal size requires shorter exposure times.

Types of Dental Radiographs

Intraoral Radiographs

  • Periapical: Shows the entire tooth (crown and root) and surrounding bone. Used to assess root and bone status, and for endodontic procedures.
  • Interproximal (Bitewing): Shows the crowns of maxillary and mandibular molars and premolars on the same film. Primarily used to detect interproximal (between teeth) caries. Roots are not fully visible.
  • Occlusal: Used to view larger areas of the jaw, helpful for studying impacted teeth or locating stones (sialoliths) in salivary gland ducts.

Extraoral Radiographs

  • Waters’ View (or similar projections): Used to visualize the maxillary sinuses (e.g., for sinusitis).
  • Cephalometric Radiograph (Teleradiography): Used primarily in orthodontics for skull and facial measurements.
  • Tomography: Used for detailed studies of specific structures, such as the Temporomandibular Joint (TMJ).
  • Panoramic Radiograph (Orthopantomogram or OPG): Provides a global overview of the entire mouth (jaws, teeth, sinuses, TMJs). Widely used in oral surgery, orthodontics, and periodontics, though detail in the anterior incisor region may be limited.

Digital and Advanced Imaging

  • Digital Radiography (Radiovisiography): Uses electronic sensors connected to a computer instead of film. Offers significant reduction in radiation dose to the patient.
  • Computed Tomography (CT): Combines X-rays with computer processing to create cross-sectional images. Valuable for complex cases, such as dental implant placement planning.
  • Magnetic Resonance Imaging (MRI): Does not use X-rays. Excellent for visualizing soft tissues; can complement radiographs for TMJ assessment.