Maxillary Anesthesia -3

Maxillary Anesthesia -3 - Middle Superior Alveolar Nerve...

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Unformatted text preview: Middle Superior Alveolar Nerve Block Block Nerve Anesthetized : Nerve Middle Superior Alveolar Nerve Middle - Maxillary premolars and buccal tissues Maxillary Areas Anesthetized Areas Pulpal anesthesia of first & second premolars Pulpal and mesiobuccal root of first molar and Buccal soft tissues and bone over same teeth Indications Indications Anesthesia of maxillary premolars only Infraorbital nerve block failure Contraindications Contraindications Infection /inflammation in area of injection Advantage Advantage Minimized number of injections Minimized volume of solution Minimized Disadvantage Disadvantage MSA nerve is only present 28% of the time Alternatives Alternatives Local infiltration (supraperiosteal) Periodontal ligament injection (PDL) Periodontal Infraorbital nerve block Infraorbital Landmarks / Area of Insertion Landmarks Mucobuccal fold above second premolar Apex of second premolar Signs and Symptoms Signs Numb upper lip Pain free dental therapy Safety Features Anatomically safe (no signifcant structures) Anatomically Relatively avascular area positive aspirations - negligible (< 3%) positive Complications are rare Technique - MSA Technique Apply topical Position patient and identify landmarks Insert needle 5-10 mm Aspirate Inject 0.9 ml of solution, slowly Failures of Anesthesia Failures Needle inserted too high, or not high enough Deposition of solution too far laterally Deposition Infraorbital Nerve Block Infraorbital Nerves Anesthetized Nerves Anterior Superior Alveolar Nerve Middle Superior Alveolar Nerve Superior Labial Nerve also also Inferior Palpebral Nerve Lateral Nasal Nerve Areas Anesthetized Areas Pulpal anesthesia of maxillary anterior teeth Pulpal anesthesia of premolars and Pulpal mesiobuccal root of first molar mesiobuccal Buccal soft tissue and bone of same teeth Lower eyelid, lateral nose, and upper lip Indications Indications Anesthesia of more than two maxillary teeth Supraperiosteal injections ineffective Supraperiosteal Inflammation/infection contraindicating local infiltration infiltration Contraindications Contraindications Discrete treatment areas (1-2 teeth only) Hemostasis Bleeding problems (eg. hemophelia, etc..) Landmarks Landmarks Mucobuccal fold above first premolar Infraorbital notch Infraorbital foramen Area of Insertion Area Mucobuccal fold above first premolar Target area Infraorbital foramen Infraorbital Neurovascular bundle Neurovascular Advantages Advantages Comparatively simple, safe technique Minimized volume of solution Minimized number of needle punctures Minimized Disadvantages Disadvantages Psychological Administrator- fear of eye involvement AdministratorPatient- apprehension of extraoral approach PatientAnatomical Difficulty defining landmarks Difficulty Alternatives Alternatives Supraperiosteal injection for each tooth Maxillary nerve block Signs and Symptoms Signs Tingling and numbness of lower eyelid, Tingling side of nose, and upper lip side Numbness in teeth and soft tissues Numbness No pain during dental therapy No Safety Features Safety Needle contacting bone Finger over infraorbital foramen Finger Technique Technique Apply topical Position patient and identify landmarks Insert needle to upper rim of infraorbital Insert upper foramen foramen Aspirate Inject 0.9 ml of solution, slowly Failures of Anesthesia Failures Bone contact below infraorbital foramen Needle deviates laterally or medially Complications Complications Hematoma (rare) Positive aspirations - 0.7 % Positive ...
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This note was uploaded on 11/10/2011 for the course PDBIO 220 taught by Professor Tomco during the Winter '09 term at BYU.

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