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Questions and Answers

What anatomical consideration primarily dictates using a supraperiosteal or PDL injection as an alternative when a PSA nerve block is contraindicated due to bleeding risks?

  • These techniques avoid the highly vascular pterygopalatine fossa, reducing hematoma risk. (correct)
  • They rely on diffusion through denser cortical bone, minimizing vascular disruption.
  • These injections have a smaller needle gauge, inherently decreasing bleeding.
  • They directly target the PSA nerve as it exits the foramen rotundum.

A patient reports experiencing numbness in their cheek following a PSA nerve block. Which anatomical structure is MOST likely involved if the local anesthetic also inadvertently anesthetized this area?

  • Infraorbital nerve
  • Nasopalatine nerve
  • Buccal nerve (correct)
  • Mental nerve

A dentist is planning to extract a maxillary first molar. While the PSA nerve block typically anesthetizes the mesiobuccal root, what additional injection is MOST often required to achieve complete pulpal anesthesia?

  • Nasopalatine nerve block
  • Greater palatine nerve block
  • Infraorbital nerve block
  • Middle superior alveolar (MSA) nerve block (correct)

Following the administration of a nasopalatine nerve block, a patient reports numbness and tingling in the area of the incisive papilla. What is the anatomical explanation for this sensation?

<p>The nasopalatine nerve traverses through the incisive foramen, located near the incisive papilla. (A)</p> Signup and view all the answers

A patient requires palatal soft tissue manipulation in the posterior maxillary region. If a greater palatine nerve block is administered, what is the anterior anatomical landmark that estimates the block's effective anesthetized border?

<p>Premolars (B)</p> Signup and view all the answers

A patient reports feeling pain during a dental procedure on their maxillary first molar, despite having received a PSA nerve block. Which anatomical variation is most likely contributing to the anesthetic failure?

<p>The mesiobuccal root of the maxillary first molar being innervated by the Middle Superior Alveolar (MSA) nerve. (A)</p> Signup and view all the answers

Following a PSA nerve block, a patient experiences swelling and discoloration in the buccal region. What immediate action should the dentist take to manage this complication?

<p>Apply pressure directly over the injection site, and advise the patient to use warm compresses after 24 hours. (C)</p> Signup and view all the answers

A dental student is about to administer a PSA nerve block. Which step is most crucial to minimize the risk of complications during the procedure?

<p>Aspirating prior to injection to avoid intravascular deposition. (A)</p> Signup and view all the answers

A dentist is considering using a PSA nerve block for multiple restorations on the maxillary molars. What is the most significant advantage of using a PSA block over local infiltration for these procedures?

<p>Anesthesia of a larger area with fewer injections. (D)</p> Signup and view all the answers

After administering a PSA nerve block, the patient reports numbness in the lower eyelid and the side of the nose. Which of the following is the most likely explanation for this occurrence?

<p>The anesthetic was inadvertently deposited near the infraorbital nerve. (D)</p> Signup and view all the answers

Flashcards

PSA block alternative

Supraperiosteal or PDL injection

PSA nerve exit point

Pterygopalatine fossa

PSA block complication

Hematoma

Nasopalatine nerve target

Palatal mucosa from canine to canine

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Greater palatine nerve target

Palatal soft tissues and bone from premolars to the posterior region

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PSA Nerve Block Target

Anesthetizes maxillary third, second, and first molars.

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PSA Block Success Rate

The success rate is approximately 95%.

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PSA Block Failure Rate (MB Root)

Failure to anesthetize the MB root of the maxillary first molar occurs in 28% of patients.

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PSA Block Needle

A 27-gauge short needle reduces hematoma risk.

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Study Notes

  • The PSA nerve block primarily anesthetizes the maxillary third, second, and first molars.
  • The PSA nerve block technique has a 95% success rate.
  • The PSA nerve block fails to anesthetize the mesiobuccal root of the maxillary first molar in 28% of patients.
  • A potential complication of the PSA nerve block is hematoma formation.
  • The recommended needle type for a PSA nerve block is a 27-gauge short needle.
  • A short needle is used in a PSA nerve block primarily to decrease the risk of hematoma.
  • An alternative injection technique recommended if the PSA nerve block is contraindicated due to bleeding risk is supraperiosteal or PDL injection.
  • The PSA nerve exits the skull through the pterygopalatine fossa.
  • The most common PSA nerve block complication is hematoma.
  • The PSA nerve supplies sensory innervation to all of the following except the hard palate.
  • The nasopalatine nerve supplies the palatal mucosa from canine to canine.
  • The greater palatine nerve block anesthetizes the palatal soft tissues and bone from the premolars to the posterior region.

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