DHS-Oral Surgery- Maxillary Nerve Block Techniques

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30 Questions

Which nerve supplies the canine and upper incisor teeth?

Anterior superior alveolar nerve

What is the area of insertion for the middle superior alveolar nerve block?

Buccal sulcus in the second premolar region

What is the target area for the middle superior alveolar nerve block?

Supraperiosteal position close to the apex of the second premolar tooth

When is the middle superior alveolar nerve block indicated?

When the ASA nerve block fails to provide pulpal anesthesia distal to the maxillary canine

What is the success rate of the MSA nerve block?

High

How much solution is deposited for the anterior superior alveolar nerve block?

1.5 mL

What does the middle superior alveolar nerve block target above or between?

4 and 5

What is the area anesthetized by the MSA nerve block?

Maxillary bone above the apex of the maxillary second premolar

What is the area anesthetized by the ASA nerve block?

Canine and upper incisor teeth

What is the area anesthetized by the MSA nerve block when present?

Premolar pulps and mesiobuccal pulp of the maxillary first permanent molar tooth

Which nerve block technique has a high success rate for anesthetizing the pulps of the maxillary third, second, and first molars?

Posterior superior alveolar nerve block (PSA)

Which nerve block technique anesthetizes the entire maxillary first molar except for the mesiobuccal root?

Posterior superior alveolar nerve block (PSA)

For extraction, which nerve block technique is needed along with palatal infiltration?

Posterior superior alveolar nerve block (PSA)

Which nerve block technique is used for anesthetizing the pulps of the maxillary premolars?

Middle superior alveolar nerve block

Which nerve block technique is associated with a high success rate for anesthetizing the pulps of the maxillary premolars?

Middle superior alveolar nerve block

Which nerve block technique is used for anesthetizing the anterior superior alveolar nerve?

Anterior superior alveolar nerve block

Which nerve block technique is used for anesthetizing the infraorbital nerve?

Infraorbital nerve block

Which nerve block technique is used for anesthetizing the greater palatine nerve?

Greater palatine nerve block

Which nerve block technique is used for anesthetizing the nasopalatine (long sphenopalatine) nerve?

Nasopalatine (long sphenopalatine nerve) block

Which nerve block technique is used for anesthetizing the maxillary nerve?

Maxillary nerve block

What is the depth of penetration for the maxillary nerve block compared to the posterior superior alveolar nerve block (PSA)?

30mm compared to 16mm

What is the success rate of positive aspiration for posterior superior alveolar nerve block (PSA)?

3.1%

What is the quantity of anesthesia for anterior superior alveolar nerve block compared to infiltration alone?

1.5 compared to 0.6

What is the success rate of positive aspiration for infraorbital nerve block?

0.7%

What is the direction of needle insertion for the posterior superior alveolar nerve block (PSA)?

45-degree angle

What is the area anesthetized by infraorbital nerve block?

Anterior superior alveolar, middle superior alveolar, and infraorbital nerves

What is the technique for infraorbital nerve block?

Palpating the infraorbital foramen, inserting the needle parallel to the tooth until bony contact is made, and slowly depositing 0.9 to 1.2 mL of anesthetic solution

What is the target area for the middle superior alveolar nerve block?

close to the apex of second premolars

What is the area of insertion for the maxillary nerve block?

At the height of the mucobuccal fold above the maxillary second molar

What is the direction of needle insertion for infraorbital nerve block?

Parallel to the tooth until bony contact is made

Study Notes

Dental Nerve Block Techniques

  • Posterior superior alveolar nerve block (PSA) is a pathway through the tissue, with the area of insertion visible and the target area imagined.
  • The entry point for maxillary nerve block is the same as PSA, but it goes deeper (30mm compared to 16mm).
  • The technique for PSA involves insertion at the height of the mucobuccal fold above the maxillary second molar, with the needle directed at a 45-degree angle.
  • To gain access, the patient's mouth is partially opened, and the needle is inserted into the height of the mucobuccal fold over the second molar.
  • The needle is advanced slowly in an upward, inward, and backward direction for PSA, at a 45-degree angle to the occlusal plane.
  • In an adult of normal size, penetration to a depth of 16mm places the needle tip in the vicinity of the foramina through which the PSA nerves enter the posterior surface of the maxilla.
  • Positive aspiration for PSA is approximately 3.1%.
  • The PSA injection is normally atraumatic due to the large tissue space available and the fact that bone is not touched.
  • Infraorbital nerve block anesthetizes the anterior superior alveolar, middle superior alveolar, and infraorbital nerves, as well as specific structured areas.
  • The technique for infraorbital nerve block involves palpating the infraorbital foramen, inserting the needle parallel to the tooth until bony contact is made, and slowly depositing 0.9 to 1.2 mL of anesthetic solution.
  • Positively aspirated aspiration for infraorbital nerve block is 0.7%.
  • Anterior superior alveolar nerve block is a combination of infiltration and nerve block, with the quantity of anesthesia being 1.5 compared to 0.6 for infiltration alone.

Test your knowledge of dental nerve block techniques with this quiz. Explore the procedures for posterior superior alveolar, maxillary, infraorbital, and anterior superior alveolar nerve blocks, including insertion points, needle direction, depths, and aspiration rates.

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