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LOCAL AND REGIONAL ANESTHESU 285

The Horizontal Injection for the bicuspids and molars excepting
the third molar. By this method several teeth may be injected
A\'ith only the one puncture of the tissues, thereby materially less-
ening the liability of infection. This injection is contraindicated
in diseased tissue.
The Perpendicular Injection is applicable for all single-rooted
teeth. The needle should generally be inserted just below the gum
margin and the point carried lingually or buccally of the apex of

Fig. 154.— This is a mandible which belongs to a class on which it is very hard to give a
mandibular injection. Note that the internal oblique line is continuous up to the sigmoid
notch. The lingula (a) is one cm. higher than normal and is only about four mm. back of
the internal oblique line. Conditions like this possibly explain why even the most expert
sometimes do not get results upon first attempt.
the tooth the anesthesia of which is desired. The solution is in-
jected without pressure and the needle does not go sub-periosteal
as in distinction from the intra-alveolar. The quantity of solu-
tion to inject is about one and a half cubic centimeters for the
horizontal injection and about one cubic centimeter for the per-
pendicular. A one-inch needle of small size is best suited for all
infiltration work.
Intra-alveolar Anesthesia has for its object the blocking of the