Techniques of max anesthesia Flashcards
what are the type of max nerve blocks?
PSA, ASA, MSA
palatal (nasopalatine, greater palatine)if
second division (V2)
what’s another name for local infiltration?
supraperiosteal injection
T/F getting the second division (V2) numb will get the rest of the max nerve blocks as well
true
T/F infra-orbital gives dental innervation
False
infra-orbital gets soft tissue numb, but not dental innervation and is useful for incision and drainage
1st max molar entire tooth ______% of the time
and not the MB root ______% of the time with PSA
72%, 28%
what are the PSA landmarks?
distal to the malar process
45 deg to the mesiodistal plane
45 deg to the buccolingual plane
15-16 depth of penetration
what are the nerves anesthetized with the ASA
ant superior alveolar
MSA (72% of the time)
infraorbital nerve
T/F ASA will hit the lower eyelid, lateral nose, and upper lip
true
where should you do the ASA penetration?
over the max 1st premolar
what is the penetration depth for ASA
15mm
how much cc’s with ASA after aspiration
1.0
where do you put pressure/massage with ASA?
into infra-orbital foramen
_______% of the time a pt has a separate MSA nerve present
28%
_______% of the time that a pt has a MSA be a branch of the ASA
72%
where would you inject for the MSA
over the max 2nd premolar at the height of ht ebuccal vestibule
what’s the penetration length for MSA
15mm
where will the nasoplaltine nerve block get numb?
the palatal soft tissue canine to canine (the “pre-maxilla”)
where should you inject for the anterior approach for the nasopalatine nerve block?
anesthetize the facial aspect of central incisors - infiltrate buccal mucosa
interseptal infiltration b/t 8-9 progressing from facial to palatal
inject incisive papilla (usually painlessly)
where is the greater palatine usually located?
just distal to the 2nd molar (b/w junction of the max alveolar process and the hard palate)
where will the greater palatine injection anesthetize?
palatal soft tissue from 1st premolar to midline of side injected
where will the second division get numb?
hemi-maxilla
-pulpal anesthesia of that side
-bone: alveolar and palatal of that side
-tissue: buccal, hard palate, some soft palate
-skin: infraorbital distribution
what is the needle at approx to enter canal for the greater palatine approach to hit the 2nd division?
45 degrees
how far do you advance for the greater palatine approach to get V2 numb?
30 mm
what percentage of the greater palatine approach for V2 block fail to negotiate?
5-15%
where and how far do you go for the high tuberosity approach to get V2 numb?
PSA: 15-16mm
high tuberosity second division: 30mm
at 30mm where should the needle lie for the high tuberosity approach for V2 block?
pterygopalatine fossa
