module 1.1

Question 1

What is local infiltration anesthesia?

Answer 1

Anesthetic deposited near small terminal nerve endings, anesthetizing a small area (1–2 teeth and surrounding structures), used mainly in the maxilla.

Question 2

What defines a nerve block anesthesia?

Answer 2

Anesthetic deposited near a large nerve trunk, anesthetizing a larger area.
Ex. IA block

Question 3

What is the trigeminal nerve?

Answer 3

The fifth cranial nerve, the main sensory nerve for the face and oral cavity and the major nerve used for dental local anesthesia.

Question 4

What is the mucobuccal fold?

Answer 4

The vestibular fold between the buccal mucosa and attached gingiva, a universal landmark for many maxillary injections.

Question 5

What is the pterygomandibular raphe?

Answer 5

A fold of tissue between the buccinator and superior pharyngeal constrictor muscles, serving as a landmark for the inferior alveolar injection.

Question 6

What is the coronoid notch?

Answer 6

The greatest concavity on the anterior border of the mandibular ramus; a landmark for IA injection.

Question 7

What is the exit foramen of the ophthalmic division (V1) of the trigeminal nerve?

Answer 7

Superior orbital fissure.

Question 8

Is the ophthalmic division (V1) sensory, motor, or both?

Answer 8

Sensory only.

Question 9

Is V1 used in local anesthesia?

Answer 9

No, it is not used in dental local anesthesia.

Question 10

What is the exit foramen of the maxillary division (V2) of the trigeminal nerve?

Answer 10

Foramen rotundum.

Question 11

Is the maxillary division (V2) sensory, motor, or both?

Answer 11

Sensory only.

Question 12

Which division is used for maxillary injections such as PSA, MSA, ASA, GP, and NP?

Answer 12

Maxillary division (V2).

Question 13

What is the exit foramen of the mandibular division (V3) of the trigeminal nerve?

Answer 13

Foramen ovale.

Question 14

Is the mandibular division (V3) sensory, motor, or both?

Answer 14

Mixed—both sensory and motor.

Question 15

Which division is used for mandibular injections like IA, Buccal, Lingual, Mental, and Incisive?

Answer 15

Mandibular division (V3).

Question 16

Which bone is relevant for PSA, MSA, and ASA injections?

Answer 16

Maxilla.

Question 17

Why is infiltration anesthesia easier in the maxilla?

Answer 17

Because the maxilla has porous bone.

Question 18

Which bone is targeted for NP and GP injections?

Answer 18

Palatine bone.

Question 19

What type of injections are given in the palatine bone area?

Answer 19

Palatal injections.

Question 20

Which bone is relevant for IA, Buccal, Lingual, Mental, and Incisive injections?

Answer 20

Mandible.

Question 21

Why is infiltration anesthesia harder in the mandible?

Answer 21

Because the mandible is dense.

Question 22

Which bone houses the foramen rotundum and foramen ovale?

Answer 22

Sphenoid bone.

Question 23

What tissues does the Posterior Superior Alveolar (PSA) injection anesthetize?

Answer 23

Pulp
periodontal ligament
osseous tissue of 1st–3rd molars
buccal gingiva
It may not anesthetize the mesiobuccal root of the 1st molar.

Question 24

What is the target area for the PSA injection?

Answer 24

Apex of the maxillary 2nd molar.

Question 24

What is the landmark for the PSA injection?

Answer 24

Height of the mucobuccal fold at a 45° angle to the occlusal plane.

Question 25

What structures are penetrated during the PSA injection?

Answer 25

Mucosa, connective tissue, and periosteum.

Question 26

Why should you avoid injecting too posteriorly during a PSA injection?

Answer 26

To prevent hematoma formation.

Question 27

What tissues does the Middle Superior Alveolar (MSA) injection anesthetize?

Answer 27

Pulp periodontal ligament osseous tissue of maxillary premolars mesiobuccal root of 1st molar (if present) buccal gingiva

Question 28

What is the target area for the MSA injection?

Answer 28

Apex of the maxillary 2nd premolar.

Question 29

What is the landmark for the MSA injection?

Answer 29

Height of the mucobuccal fold at 20 degrees, parallel to the long axis of the tooth.

Question 30

What tissues does the Anterior Superior Alveolar (ASA) injection anesthetize?

Answer 30

Pulp osseous facial tissues from canine to central incisor

Question 31

What is the target for the ASA injection?

Answer 31

Just anterior to the canine eminence.

Question 32

What is the landmark for the ASA injection?

Answer 32

Height of the mucobuccal fold.

Question 33

What tissues does the Greater Palatine (GP) injection anesthetize?

Answer 33

Palatal soft tissue from the first premolar posteriorly, but no pulpal anesthesia.

Question 34

What is the target for the GP injection?

Answer 34

Greater palatine foramen.

Question 35

What landmark technique is used for the GP and NP injection?

Answer 35

Cotton tip applicator for pressure anesthesia.

Question 36

What tissues does the Nasopalatine (NP) injection anesthetize?

Answer 36

Palatal tissue from canine to canine; no pulpal anesthesia.

Question 37

What is the target for the NP injection?

Answer 37

Incisive foramen under the incisive papilla.

Question 38

What tissues does the Inferior Alveolar (IA) block anesthetize?

Answer 38

Pulpal and osseous tissue of the entire mandibular quadrant, plus lingual and facial soft tissues anterior to the mental foramen.

Question 39

What is the target area for the IA block?

Answer 39

Mandibular foramen, about three-quarters between the coronoid notch and posterior border.

Question 40

What landmarks help locate the IA block injection site?

Answer 40

Coronoid notch, occlusal plane, and pterygomandibular raphe.

Question 41

What is the typical needle depth for the IA block?

Answer 41

20–25 millimeters.

Question 42

What tissues are anesthetized by the lingual nerve block?

Answer 42

Lingual gingiva, floor of mouth, and anterior tongue.

Question 43

How is the lingual nerve anesthetized during an IA block?

Answer 43

By diffusion from the IA injection.

Question 44

What tissues are anesthetized by the long buccal nerve block?

Answer 44

Buccal gingiva of mandibular molars.

Question 45

Where is the target site for the long buccal injection?

Answer 45

Mucosa distal and buccal to the last mandibular molar.

Question 46

What landmark guides the long buccal injection?

Answer 46

Needle held parallel to the occlusal plane, moving laterally.

Question 47

What tissues does the mental nerve block anesthetize?

Answer 47

Soft tissues only — chin, lower lip, and buccal mucosa of premolars and anterior teeth.

Question 48

Where is the mental nerve block target?

Answer 48

Anterior to the mental foramen, between the 1st and 2nd premolars.

Question 49

What structures are penetrated in the mental nerve block?

Answer 49

Mucosa and submucosa, but no pulp.

Question 50

What tissues does the incisive nerve block anesthetize?

Answer 50

Pulpal and facial tissues of anterior teeth and premolars.

Question 51

How is the anesthetic delivered in the incisive nerve block?

Answer 51

Injection at the same site as the mental block, followed by massaging the area to force anesthetic into the mental foramen.

Question 52

Why should injections be avoided in infected or inflamed tissue?

Answer 52

Because anesthetic diffusion is poor and there is a risk of spreading the infection.