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intro to OS and pain management > techniques maxillary anethesia > Flashcards

techniques maxillary anethesia Flashcards

1
Q

where is the PSA located

A

pterygopalatine fossa

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2
Q

PSA Anesthetized Area

A

palatal tissue not included

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3
Q

PSA Technique

A
  1. 45 degrees upward,backward, and in
  2. 16mm past height of vestibule
  3. Aspirate, then Inject 0.9ml-1.8ml
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4
Q

why must we aspirate with PSA

A

pull back gently to see if blood enter needle= do not inject and reposition injection
req a - aspiration before we inject

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5
Q

PSA Nerve Block
Areas Anesthetized

A

 Maxillary molar tooth pulps
 MB root of 1st molar in 72%
 Buccal periodontium and bone

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6
Q

PSA Nerve Block
Advantages

A

 Atraumatic
 Success rate > 95%
 Minimal volume of anesthetic

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7
Q

PSA Nerve Block
Disadvantages

A

 Disfiguring hematoma risk (pterygoid plexus) must aspirate
 MB root of 1st molar missed in 28%
 Aspiration rate ~3%

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8
Q

Middle Superior Alveolar
Nerve
presence?
MB root 1st molar?
perio/bone?

A

 Present in some patients
 MB root of 1st molar in 28%
 Buccal periodontium and bone

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9
Q

MSA Anesthetized Area

A
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10
Q

MSA Technique

A
  1. Inject well above premolar
    apices, bevel facing bone
  2. 0.9 to 1.2 ml
    3.
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11
Q

MSA Nerve Block
Areas Anesthetized

A

 Premolars
 MB root of first molar, 28%
 Buccal periodontium and bone

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12
Q

MSA Nerve Block
Indications

A

 To treat both premolars
 When a nerve block is indicated
 When supraperiosteal injection has
failed
 When infraorbital block does not
anesthetize premolars

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13
Q

Anterior Superior Alveolar
Nerve / Infraorbital Nerve Block

A

nn out of infraorbital foramen
1.Locate the Foramen by Palpation
2.Foramen ~ 16 mm Above Vestibule
2. Insertion Depth ~ ½ Long Needle
3. Orient Needle Bevel Towards Bone
3. Needle Contacts Roof of Foramen
2. Aspirate and Inject 0.9 to 1.2 ml
3. Anesthetic Directed into Canal
4. Maintain Pressure During Injection/ and 1 min after

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14
Q

ASA Nerve Block
Areas Anesthetized

A

 Maxillary central through canine
 Premolars
 MB root of first molar in 28% of patients
 Buccal periodontium and bone
 Lower eyelid, side of nose, upper lip

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15
Q

ASA Nerve Block
Indications

A

 Procedures on two or more teeth
 Inflammation or infection
 Dense cortical bone making
supraperiosteal injections ineffective

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16
Q

Supraperiosteal Injection/ Local Infiltration anetghesized area

A
17
Q

Maxillary Labial Bone Is:

A

Maxillary Labial Bone Is Porous

18
Q

supraperiosteal injection technique

A
  1. Anesthetic Is Placed Apical to Apex
  2. Insert Superior to Root Apex
  3. Orient Needle Bevel Towards
    Bone
    insert to Level Above Tooth Apex
    Inject 0.6 ml of anesthetic
19
Q

Supraperiosteal Injection
Areas Anesthetized

A

 Tooth
 Buccal periodontium
and bone
 Labial or buccal
mucosa

20
Q

Supraperiosteal Injection
Indications

A

 Procedures on one tooth
 Soft tissue surgery in a small area

21
Q

Supraperiosteal Injection
Advantages

A

 Simple
 High success rate

22
Q

Supraperiosteal Injection Disadvantages

A
  • Not useful in inflamed area
  • Large volumes needed to treat
    multiple teeth
23
Q

target for palatal anesthesia

A

Greater Palatine Nerve

24
Q

Greater Palatine Nerve Block
steps

A
  1. Locate Foramen With Cotton Tip
  2. Apply Topical for 2 Minutes
  3. Move Applicator Over Foramen –
    Apply Direct Pressure 30 Seconds
  4. Place Needle Bevel Against Tissue
    and Bow the Needle
  5. Administer a Few Drops of Local
  6. Straighten and Advance the Needle
  7. Contact Bone
  8. Aspirate, Deposit 0.45 to 0.6 ml
25
Q

Greater Palatine Nerve
Block Areas Anesthetized

A

 Posterior portion of hard palate
 Overlying soft tissues
 No anesthesia of teeth

26
Q

Greater Palatine Injection
Indications

A

 When palatal soft tissue anesthesia
is needed – extractions, subgingival
restorations, etc.
 Pain control during periodontal or
oral surgical procedures

27
Q

ant palate anesthesia target

A

NP nn

28
Q

Nasopalatine Nerve Block steps

A
  1. Apply Topical for Two Minutes to incisive papilla
  2. **Apply Direct Pressure
  3. Contact Bone, Administer 0.45 ml
29
Q

Trans-Papillary Approach of NP block steps

A
  1. apply topical lateral to frenum
  2. blanching of labial tissue
  3. insert needle thru papilla towards palate
  4. administer 0.3mL
30
Q

Nasopalatine Nerve Block
Areas Anesthetized

A

 Anterior portion of hard palate
 Both hard and soft tissues
 No anesthesia of teeth

31
Q

Nasopalatine Injection Indications

A

 When palatal soft tissue anesthesia
is needed – extractions, subgingival
restorations, etc.
 Pain control during periodontal or
oral surgical procedures

32
Q

Second Division Nerve Block/
Maxillary Nerve Block goal and approaches

A

goal to anesthesize entire CNV2
high tuberosity and greater palatine approaches

33
Q

Maxillary Nerve Block
High Tuberosity Approach
Advantages

A
  • Atraumatic
  • 95 % success rate
  • Minimizes volume of local
34
Q

Maxillary Nerve Block
High Tuberosity Approach
Disadvantages

A
  • Risk of hematoma
  • Absent bony landmarks
  • Lack of hemostasis
35
Q

Maxillary Nerve Block
Greater Palatine Canal Approach
Advantages

A
  • Usually atraumatic
  • 95 % success rate
  • Minimizes volume of local
36
Q

Maxillary Nerve Block
Greater Palatine Canal Approach
Disadvantages

A
  • Lack of hemostasis
  • Potentially painful injection

intro to OS and pain management (8 decks)

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