Clinical Questions

Question 1

You are a dentist that wants to extract a maxillary 1st molar on your patient.

Explain which nerve you will anesthetize. How will you ensure your needle gets to that nerve (ie where do you inject?)

Your patient continues to feel significant pain during the extraction. Why is this? What can you do?

Answer 1

Posterior Superior Alveolar Nerve needs to be blocked

Inject above the maxillary 2nd molar at an angle

May not fully anesthetize the mesiobuccal root of the 1st max molar due to innervation from the middle superior alveolar nerve

Perform a middle superior alveolar nerve block. Insert needle superior of maxillary 2nd premolar.