1. Made by :
Dr. Mustafa Altayawi
LOCAL ANESTHETIC OF MAXILLARY
dr.mustafa_altayawi
2. LOCAL ANESTHETICS
• Block nerve conduction of sensory impulses and
in higher concentration ,motor impulses from
periphery to the CNS.
• Blocking of sodium channels.
3. ANESTHESIA MAXILLARY
• There are three major type of injection that can be performed in
the maxilla in order to control the pain
• 1- local infiltration
• 2- field block
• 3- nerve block
4. LOCAL INFILTRATION
• Performed in the maxilla due to the thin cortical nature of the
bone .
• Supraperiosteal injections.
• Intraseptal injections.
• Periodontal ligament injections.
5. FIELD BLOCK
• Local anesthetic is deposited toward larger terminal nerve
branches.
• Periapical injections.
6. NERVE BLOCK
• Local anesthetic deposited near main nerve trunk.
• Posterior superior alveolar.
• Middle superior alveolar.
• Anterior superior alveolar.
• Infraorbital nerve.
• Greater palatine nerve.
• Nasopalatine nerve.
7. POSTERIOR SUPERIOR NERVE
• Used to anesthetize the pulpal tissue corresponding alveolar
bone and buccal gingival tissue to the maxillary 1st, 2nd, 3rd
molars.
• insertion, height of mucobuccal fold between 1st and 2nd molar.
• Insert about 15-20mm.
8. MIDDLE SUPERIOR ALVEOLAR NERVE
• Used to anesthetize the maxillary premolars, corresponding
alveolus and buccal gingival tissue.
• Used if infraorbital block fails to anesthetize the premolars.
• Insertion, height of mucobuccal fold in the area between 1st and
2nd premolar.
• Insert about 10-15mm
9. ANTERIOR SUPERIOR NERVE
• Used to anesthetize the maxillary canine, the central and lateral
incisors, and the mucosa above these teeth.
• Insertion, height of mucobuccal fold in area of lateral incisor and
canine.
• Insert about 10-15mm.
10. INFRAORBITAL NERVE BLOCK
• Used to anesthetize the maxillary 1st and 2nd premolars, canine,
lateral incisor,central, corresponding alveolar bone, and buccal
gingiva.
• Cause anesthesia to the lower eyelid, lateral aspect of nasel
skin tissue, and skin of infraorbital region.
• Palpate infraorbital foramen extra-orally and place orally thumb
or index finger on the region.
• Retract the upper lip and buccal mucosa.
• Area of insertion is the mucobuccal fold of the 1st premolar /
canine area.
11.
12. GREATER PALATINE NERVE BLOCK
• Used to anesthetize the palatal soft tissue of the posterior teeth to the
maxillary canine and corresponding alveolus and hard palate.
• Area of insertion is 1cm medial from 1st and 2nd maxillary molar on the hard
palate.
• Depth usually less than 10mm.
13. NASOPALATINE NERVE BLOCK
• Used to anesthitize soft and hard tissue of maxillary anterior
palate from canine to canine.
• Area of insertion is incisive papilla into incisive foramen.
• Depth of penetration is lees than 10mm
14. MAXILLARY NERVE BLOCK
• Used to anesthetize maxillary teeth, alveolus, hard and soft
tissue on the palate, gingiva ,and the skin of the lower eyelid,
lateral aspect of nose,cheek and upper lip and mucosa on side.
• High tuberosity approach.
• Greater palatine canal approach.
15. HIGH TUBEROSITY APPROACH
• Area of injection is height of mucobuccal fold of maxillary 2nd
molar.
• Advance at 45 superior and medial same as PSA block .
• Insert of needle 30mm.
16. GREATER PALATINE CANAL APPROACH
• Area of insertion is greater palatine canal.
• Target area is the maxillary nerve in the pterygopalatine fossa .
• Insert to depth of 30mm.
