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Maxillary Anesthesia -2


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Unformatted text preview: MAXILLARY ANESTHESIA MAXILLARY Techniques of Maxillary Anesthesia Anesthesia Local Infiltration Field Block Nerve Block Maxillary Injection Techniques Maxillary Supraperiosteal Periodontal ligament Intraseptal injection Posterior superior alveolar nerve block Middle superior alveolar nerve block Maxillary Injection Techniques Maxillary Anterior superior alveolar nerve block Maxillary (second division) nerve block Greater (anterior) palatine nerve block Nasopalatine nerve block Supraperiosteal Injection Supraperiosteal Indications Indications Pulpal anesthesia of one or two maxillary Pulpal teeth Soft tissue anesthesia when indicated Soft Hemostasis Hemostasis Contraindications Contraindications Infection or acute inflammation in the area Dense bone covering apices of teeth Advantages Advantages High success rate (>95%) Technically easy injection Usually entirely atraumatic Areas Anesthetized Entire area innervated by the large terminal nerve branches: nerve Tooth pulp and root area Tooth Buccal periosteum Buccal Mucous membrane and connective tissue Mucous Disadvantages Disadvantages Not suitable for large areas Multiple needle insertions Multiple Large volumes of anethetic solution Percent Positive Aspiration: Negligible, but possible (<1%) Negligible, Alternatives Alternatives Periodontal ligament injection Regional nerve block Technique Technique Apply topical Landmarks - mucobuccal fold long axis of tooth long Insert needle at height of mucobuccal fold Target area - apex of tooth Aspirate, deposit approx. 0.6-1 ml solution Signs and Symptoms Signs Numbness Absence of pain during dental therapy Safety Feature Safety Minimum opportunity for intravascular administration Failures of Anesthesia Failures Inadequate needle penetration - not adjacent to tooth apex not Needle too far from bone Needle Posterior Superior Alveolar Nerve Block Nerve Nerve Anesthetized: Posterior Superior Alveolar Nerve (PSA) Posterior - for maxillary molars and buccal tissue Indications for PSA Block Indications First or second maxillary molar Supraperiosteal injection is contraindicated Contraindication Contraindication Risk of hemorrhage is too great (eg. hemophelia, coumadin) (eg. Advantages Advantages Atraumatic Atraumatic High success rate High Less number of injections Minimize amount of local used Minimize Disadvantages Disadvantages Risk of hematoma Does not anesthetize first molar completely Does not first No bony landmarks Positive Aspiration Positive Approximately 3.1% Landmarks Landmarks Mucobuccal fold Maxillary tuberosity Zygomatic process of maxilla Area of Insertion Area Mucobuccal fold above maxillary second Mucobuccal molar molar Technique Technique 25 gauge, long needle Position patient and identify landmarks Advance needle upward, inward and Advance backward backward Aspirate, inject 1.8 ml of solution Failures of Anesthesia Failures Needle too lateral Needle not deep enough Needle too far superior Complications Complications Hematoma Mandibular anesthesia ...
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