Maxillary Anesthesia

Question 1

What nerve supplies the upper anteriors and the gingiva?

Answer 1

3-3 supplied by anterior superior alveolar nerve

Question 2

What nerve supplies the premolars and the gingiva?

Answer 2

Middle superior alveolar nerve

Question 3

What nerve supplies the molars and the gingiva?

Answer 3

Posterior superior alveolar nerve.

BUT

Mesiobuccal cusp of upper 6 supplied by middle superior alveolar nerve

Question 4

What nerve supplies the maxillary sulcus?

Answer 4

Long buccal nerve

Question 5

What nerve supplies the palate around the anterior?

Answer 5

3-3 supplied by incisive branch of nasopalatine nerve

Question 6

What nerve supplies the rest of the hard palate?

Answer 6

Greater palatine nerve

Question 7

What nerve supplies the soft palate?

Answer 7

Lesser palatine nerve

Question 8

What is an advantage of blocks rather than infiltration regarding infection?

Answer 8

• An advantage of regional block is that because it anesthetizes a larger area, you can deposit it away from site of infection to reduce the chance of spreading the infection

Question 9

How is a greater palatine nerve block given?

Answer 9

Given 1cm medial and adjacent to maxillary second molar.

Question 10

When is greater palatine nerve block indicated?

Answer 10

When you have to do extensive palatal soft tissue surgery (reduces dose and more comfortable than multiple palatal infiltrations.

Question 11

What is the concentration of lidocaine and adrenaline in lignospan?

Answer 11

20mg/mL lidocaine, 12.5micrograms/mL adrenaline.

Question 12

What does a 2.2mL cartridge of lignospan special 2% contain?

Answer 12

44mg lidocaine, 27.5 micrograms adrenaline.

Question 13

What are two anesthetics without a vasoconstrictor?

Answer 13

mepivicaine, prilocaine PLAIN

Question 14

For what condition would it be good practice to reduce dose?

Answer 14

• Most drugs are broken down in liver via amidases. IN LIVER DISEASE, PATIENT WONT EFFECTIVELY BREAK THE DRIG DOWN AND YOU MAY GET HIGHER CIRCULATING DOSES. HENCE GOOD PRACTICE TO REDUCE DOSE.

Question 15

What is the half life of articaine? Where is it broken down?

Answer 15

• Articaine broken down in PLASMA AND LIVER.
• 0.5 hours.

Question 16

What should be avoided in pregnancy?

Answer 16

Articaine, felypressin (vasoconstrictor).

Question 17

What are 3 advantages of vasoconstrictors?

Answer 17

• increase speed of onset
• extend duration of anesthesia (because it is taken up more slowly in the blood)
• lower blood levels of LA

Question 18

What is the maximum dose of lidocaine?

Answer 18

4.4mg/kg up to a MAX OF 300mg.

A CARTRIDGE PER 10 KG, MAXIMUM OF 7.

Question 19

When should lidocaine with adrenaline not be used?

Answer 19

• Severe cardiac dysrhythmia
• unstable angina

Question 20

What is the concentration of articaine and adrenaline in septanest?

Answer 20

4%

40mg/mL 1:100,000 OR 1:200,000 adrenaline

Question 21

Contents of a 2.2mL cartridge of 4% septanest?

Answer 21

88mg articaine in a 2.2mL cartridge.

Question 22

Maximum dose of septanest 4%?

Answer 22

7mg/ kg up to a MAX OF 300mg.

Question 23

4 indications to reduce anesthetic dose

Answer 23

• Liver disease (impaired metabolism)
• Calcium channel blockers
• Beta blockers
• Drug abuse