Survey
* Your assessment is very important for improving the work of artificial intelligence, which forms the content of this project
Download Middle Superior Alveolar Nerve Block
Document related concepts
no text concepts found
Transcript
Middle Superior Alveolar Nerve Block Nerve Anesthetized : Middle Superior Alveolar Nerve - Maxillary premolars and buccal tissues Areas Anesthetized Pulpal anesthesia of first & second premolars and mesiobuccal root of first molar Buccal soft tissues and bone over same teeth Indications Anesthesia of maxillary premolars only Infraorbital nerve block failure Contraindications Infection /inflammation in area of injection Advantage Minimized number of injections Minimized volume of solution Disadvantage MSA nerve is only present 28% of the time Alternatives Local infiltration (supraperiosteal) Periodontal ligament injection (PDL) Infraorbital nerve block Landmarks / Area of Insertion Mucobuccal fold above second premolar Apex of second premolar Signs and Symptoms Numb upper lip Pain free dental therapy Safety Features Anatomically safe (no signifcant structures) Relatively avascular area positive aspirations - negligible (< 3%) Complications are rare Technique - MSA Apply topical Position patient and identify landmarks Insert needle 5-10 mm Aspirate Inject 0.9 ml of solution, slowly Failures of Anesthesia Needle inserted too high, or not high enough Deposition of solution too far laterally Infraorbital Nerve Block Nerves Anesthetized Anterior Superior Alveolar Nerve Middle Superior Alveolar Nerve Superior Labial Nerve also Inferior Palpebral Nerve Lateral Nasal Nerve Areas Anesthetized Pulpal anesthesia of maxillary anterior teeth Pulpal anesthesia of premolars and mesiobuccal root of first molar Buccal soft tissue and bone of same teeth Lower eyelid, lateral nose, and upper lip Indications Anesthesia of more than two maxillary teeth Supraperiosteal injections ineffective Inflammation/infection contraindicating local infiltration Contraindications Discrete treatment areas (1-2 teeth only) Hemostasis Bleeding problems (eg. hemophelia, etc..) Landmarks Mucobuccal fold above first premolar Infraorbital notch Infraorbital foramen Area of Insertion Mucobuccal fold above first premolar Target area Infraorbital foramen Neurovascular bundle Advantages Comparatively simple, safe technique Minimized volume of solution Minimized number of needle punctures Disadvantages Psychological Administrator- fear of eye involvement Patient- apprehension of extraoral approach Anatomical Difficulty defining landmarks Alternatives Supraperiosteal injection for each tooth Maxillary nerve block Signs and Symptoms Tingling and numbness of lower eyelid, side of nose, and upper lip Numbness in teeth and soft tissues No pain during dental therapy Safety Features Needle contacting bone Finger over infraorbital foramen Technique Apply topical Position patient and identify landmarks Insert needle to upper rim of infraorbital foramen Aspirate Inject 0.9 ml of solution, slowly Failures of Anesthesia Bone contact below infraorbital foramen Needle deviates laterally or medially Complications Hematoma (rare) Positive aspirations - 0.7 %
Related documents