Maxillary

Question 1

What are the maxillary anesthetic techniques?

Answer 1

• Infiltration:
  
  • Buccal infiltration
  • Palatal Infiltration
• Nerve Block
  
  • Incisive NB
  • Anterior & Middle Superior Alveolar NB
  • Posterior Superior Alveolar NB
  • Palatine NB
  • Maxillary NB

Question 2

Nerve Supply of Maxillary Teeth

Answer 2

• Pulp, investing structures, Buccal mucoperiosteum
  
  • Anterior Teeth (6→11)
    
    • Anterior Superior Alveolar Nerve
  • Premolars & MB root of 1st molar (4,5,12,13)
    
    • Middle Superior Alveolar Nerve
  • Molars (except MB root of 1st molar)
    
    • Posterior Superior Alveolar Nerve
• Palatal Mucoperiosteum
  
  • Anterior Teeth
    
    • Nasopalatine N
  • Posterior Teeth (premolars & molars)
    
    • Greater palatine N

Question 3

What areas are anesthetized by PSA NB?

Answer 3

• areas:
  
  • Maxillary molars (3rd, 2nd, 1st)
    
    • 1st MB root→ MSA 28%→infiltration
  • buccal periodontium/gingiva
  • buccal bone

Question 4

What are the landmarks for a PSA NB?

Answer 4

• way above the 2nd molar
  
  • Distal to the 2nd molar
• Mucobuccal Fold
• Maxillary Tuberosity
• Zygomatic process

Question 5

For the PSA NB: What is the orientation of the needle?

Answer 5

• 45 degrees upward, inward, and backward
• enter the mucobuccal fold
• behind the zygomatic process

Question 6

Greater Palatine Nerve Block: Indications

Answer 6

• dental procedure of the hard palate and overlying soft tissues
• distal to the canine
• >2 teeth

Question 7

Greater Palatine Nerve Block: Areas Anesthetized

Answer 7

• Molars→1st premolar
• Posterior hard palate
  
  • & overlying soft tissue

Question 8

Greater Palatine Nerve Block: Landmarks

Answer 8

• Greater Palatine Foramen- depressible tissue around 3rd molar
• junction of maxillary alveolar process & palatine bone

Question 9

Inferior Alveolar Nerve Block: Nerves anesthetized

Answer 9

• Inferior Alveolar N. (Branch of V3)
• Incisive N
• Mental N
• Lingual N (2nd area of deposition)

Question 10

Inferior Alveolar Nerve Block: What areas are anesthetized?

Answer 10

• Mandibular teeth
  
  • 3rd molar→central incisor
• Buccal mucoperiosteum and mucous membrane
  
  • Anterior to mental foramen (2nd premolar)
  • mental nerve
• Anterior ⅔ of tongue and floor of mouth
  
  • lingual nerve
• Lingual soft tissues & periosteum
  
  • Lingual Nerve

Question 11

Inferior Alveolar Nerve Block: Target Area

Answer 11

• Inferior Alveolar N. as it passes down toward the mandibular foramen
  
  • before it enters

Question 12

Inferior Alveolar Nerve Block: Landmarks

Answer 12

• Coronoid Notch (horizontal)
• Pterygomandibular raphe (Vertical Position)
  
  • ¾=site of injection
• Occlusal Plane of mandibular posterior teeth

Question 13

Inferior Alveolar Nerve Block: Depth and amount of injection

Answer 13

• Depth: ⅔ to ¾ length of needle
• Amount: 0.9-1.7mls

Question 14

Mental Nerve Block: what nerves are anesthetized?

Answer 14

• Mental Nerve

Question 15

Mental Nerve Block: Target Area

Answer 15

• Mental N as it exits the mental foramen
  
  • b/w 1st and 2nd premolar apices

Question 16

Mental Nerve Block: Landmarks

Answer 16

• Mandibular Premolars
• mucobuccal fold

Question 17

Mental Nerve Block: What areas are anesthetized?

Answer 17

• Buccal Mucous Membranes from mental foramen to midline
• Skin of chin and lip

Question 18

Mental Nerve Block: Depth and amount injected?

Answer 18

• Depth: 5-6mm
• Amount: 0.6mls (⅓ cartridge)