Maxillary LA techniques

Question 1

Label the nerves

Answer 1

Question 2

What teeth does the following nerves innervate:

Anterior Superior Alveolar nerve

Middle Superior Alveolar nerve

Posterior Superior Alveolar nerve

Answer 2

Anterior Superior Alveolar nerve. 1,2,3

Middle Superior Alveolar nerve. 4,5 and mesial buccal root of 6

Posterior Superior Alveolar nerve. rest of 6,7,8

Question 3

Label the nerves

Answer 3

Question 4

What are the Local Anaesthetic Techniques?

Answer 4

▪ Topical anaesthesia

▪ Infiltration anaesthesia

▪ Regional (block) anaesthesia

▪ Supplementary techniques:

– Intraosseous anaesthesia

– Intraligamentary anaesthesia

– Intrapapillary anaesthesia

– Intra-pocket anaesthesia

– Computer controlled anaesthesia

Question 5

What is Topical (Surface) Anaesthesia uses?

Answer 5

▪ Uses:

– aid to pain-free injections

– very minor surgical procedures

– abscess incision

– rubber dam clamps

Question 6

The 2 main techniques are Infiltration and Regional (block). What are the differences?

Answer 6

Infiltration

▪ Easy

▪ Safe

▪ Low risk of intravascular administration

▪ Low risk of nerve injury

▪ Local Haemostasis

▪ Local diffusion required

▪ Acts on nerve ‘endings’ rather than trunk

Regional (block)

▪ Can be difficult

▪ Less safe

▪ Higher risk of IV admin.

▪ Higher risk of nerve injury

▪ Acts on nerve trunk

▪ Widespread effect from single injection

▪ Can deposit away from infected areas

Question 7

What is the technique for giving Infiltration Anaesthesia?

Answer 7

▪ Deposition / diffusion of LA solution close to, or in the target tissue.

▪ Its efficacy governed by the ability of the solution to reach the target

▪ For teeth, the target is the tooth apex

▪ Use a short needle (25mm - blue cap)

Question 8

Where will Infiltration technique be more difficult to work?

Answer 8

Thicker Bone due to Zygomatic Process

Divergent Roots

Question 9

What is the most appropriate anaesthetic in the maxilla?

Answer 9

normally lidocaine in maxilla