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MAXILLARY ANESTHESIA

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Insert needle at height of mucobuccal fold. Target area - apex of tooth ... 25 gauge, long needle. Position patient and identify landmarks ... – PowerPoint PPT presentation

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Title: MAXILLARY ANESTHESIA


1
MAXILLARY ANESTHESIA
2
Techniques of Maxillary Anesthesia
  • Local Infiltration
  • Field Block
  • Nerve Block

3
Maxillary Injection Techniques
  • Supraperiosteal
  • Periodontal ligament
  • Intraseptal injection
  • Posterior superior alveolar nerve block
  • Middle superior alveolar nerve block

4
Maxillary Injection Techniques
  • Anterior superior alveolar nerve block
  • Maxillary (second division) nerve block
  • Greater (anterior) palatine nerve block
  • Nasopalatine nerve block

5
Supraperiosteal Injection
6
Indications
  • Pulpal anesthesia of one or two maxillary teeth
  • Soft tissue anesthesia when indicated
  • Hemostasis

7
Contraindications
  • Infection or acute inflammation in the area
  • Dense bone covering apices of teeth

8
Advantages
  • High success rate (gt95)
  • Technically easy injection
  • Usually entirely atraumatic

9
Areas Anesthetized
  • Entire area innervated by the large terminal
    nerve branches
  • Tooth pulp and root area
  • Buccal periosteum
  • Mucous membrane and connective tissue

10
Disadvantages
  • Not suitable for large areas
  • Multiple needle insertions
  • Large volumes of anethetic solution

11
Percent Positive Aspiration
  • Negligible, but possible (lt1)

12
Alternatives
  • Periodontal ligament injection
  • Regional nerve block

13
Technique
  • Apply topical
  • Landmarks - mucobuccal fold
  • long axis of tooth
  • Insert needle at height of mucobuccal fold
  • Target area - apex of tooth
  • Aspirate, deposit approx. 0.6-1 ml solution

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Signs and Symptoms
  • Numbness
  • Absence of pain during dental therapy

20
Safety Feature
  • Minimum opportunity for intravascular
  • administration

21
Failures of Anesthesia
  • Inadequate needle penetration
  • - not adjacent to tooth apex
  • Needle too far from bone

22
Posterior Superior Alveolar Nerve Block
  • Nerve Anesthetized
  • Posterior Superior Alveolar Nerve (PSA)
  • - for maxillary molars and buccal tissue

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Indications for PSA Block
  • First or second maxillary molar
  • Supraperiosteal injection is contraindicated

25
Contraindication
  • Risk of hemorrhage is too great
  • (eg. hemophelia, coumadin)

26
Advantages
  • Atraumatic
  • High success rate
  • Less number of injections
  • Minimize amount of local used

27
Disadvantages
  • Risk of hematoma
  • Does not anesthetize first molar completely
  • No bony landmarks

28
Positive Aspiration
  • Approximately 3.1

29
Landmarks
  • Mucobuccal fold
  • Maxillary tuberosity
  • Zygomatic process of maxilla

30
Area of Insertion
  • Mucobuccal fold above maxillary second molar

31
Technique
  • 25 gauge, long needle
  • Position patient and identify landmarks
  • Advance needle upward, inward and backward
  • Aspirate, inject 1.8 ml of solution

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Failures of Anesthesia
  • Needle too lateral
  • Needle not deep enough
  • Needle too far superior

35
Complications
  • Hematoma
  • Mandibular anesthesia
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