Maxillary Anesthesia -4

Maxillary Anesthesia -4 - PALATAL ANESTHESIA PALATAL...

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Unformatted text preview: PALATAL ANESTHESIA PALATAL Greater Palatine Nerve Block Greater Anterior Palatine Nerve Posterior portion of hard palate and overlying soft tissues overlying Anteriorly to 1st premolar Anteriorly Medially to midline Medially Greater Palatine Nerve Block Greater Indications Pain control in posterior palatal hard and/or soft tissues soft Contraindications Inflammation / infection at injection site Inflammation Only small area necessary (eg. 1-2 teeth) Only Greater Palatine Nerve Block Greater Advantages Minimizes penetrations and discomfort Minimizes Minimizes volume of solution (0.5 ml) Minimizes Disadvantages Limited hemostasis Limited Potentially traumatic Potentially Greater Palatine Nerve Block Greater Alternatives Local infiltration in each area Local Maxillary Nerve Block Maxillary Aspiration < 1% positive 1% Greater Palatine Nerve Block Greater Landmarks Greater palatine foramen Greater Junction of alveolus and palatine bone Junction Area of Insertion Soft tissue anterior to foramen, from opposite side opposite Greater Palatine Nerve Block Greater Precautions Do not enter canal Do enter Signs & symptoms Numb posterior palate; painfree treatment Numb Safety features Bone contacted; aspiration Bone Greater Palatine Nerve Block Greater Technique Position - open wide, extend & turn head Position Cotton swab - identify landmarks, topical Cotton Approach - bevel to tissue, advance to bone Approach Aspirate; inject 0.5 ml slowly Aspirate; Greater Palatine Nerve Block Greater Failure Overlap of fibers from Nasopalatine nerve Overlap Injection too anterior Injection Complications Soft tissue ischemia / necrosis Soft Post injection pain, hematoma Post NASOPALATINE NERVE BLOCK NASOPALATINE Nasopalatine Nerve Block Nasopalatine Indications Pain control in anterior hard and/or soft tissues tissues Contraindications Inflammation / infection at injection site Inflammation Only small area necessary (eg. 1-2 teeth) Only Nasopalatine Nerve Block Nasopalatine Advantages Minimizes needle penetrations Minimizes Minimizes volume of solution (0.4 ml) Minimizes Disadvantages Limited hemostasis Limited Potentially traumatic Potentially Nasopalatine Nerve Block Nasopalatine Alternatives Local infiltration Local Maxillary Nerve Block Maxillary Aspiration < 1% positive 1% Nasopalatine Nerve Block Nasopalatine Precautions Do not inject directly into papilla/canal Do Inject slowly, with small volume Inject Signs / symptoms Numb anterior palate; painfree treatment Numb Safety features Bone contacted; aspiration Bone Nasopalatine Nerve Block Nasopalatine Technique Position - open wide, extend head Position Landmarks - incisive papilla, central incisors incisors Approach - lateral to incisive papilla, starting with cotton swab, topical starting Deposit approx. 0.4 ml / 30 sec Nasopalatine Nerve Block Nasopalatine Failure May be only unilateral May May have overlap with Greater Palatine May Complications Ischemia, tissue necrosis Ischemia, Others rare Others ...
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