Main Factors :
- Selection of suitable syringe and needle
- Utilization of proper LA.
- Insertion of needle at correct site
Maxillary LA Techniques
- Posterior superior alveolar nerve block
- Infraorbital nerve block
- Nasopalatine nerve block
- Maxillary nerve block
- Greater palatine nerve block
- Anterior superior nerve block
- Middle superior nerve block
Mandibular Nerve Block
- Mental nerve block
- Inferior alveolar nerve block
- Lingual nerve block
- Mandibular nerve block
Posterior Superior Alveolar Nerve Block
Landmark :
Mucobuccal fold, maxillary tuberosity, zygomatic process of maxilla.
Areas Anesthetized :
- Pulp of maxillary 3rd, 2nd and 1st molar (except mesiobuccal root)
- Buccal periodontium and bone overlying these teeth
Infraorbital Nerve Block
Landmark :
The Infraorbital foramen can be approximated by having a patient look straight ahead and imagining a line down from the pupil to the inferior border of the infraorbital ridge, bicuspid teeth, and mental foramen. Find the inferior orbital rim with the index and middle fingers of the non-injecting hand.
Nasopalatine Nerve Block
Landmark :
The location for this injection is 0.5 cm posterior to the central incisors at the midline. Look for a slight soft tissue elevation; this is the incisive papilla, which overlies the incisive foramen.
Greater Palatine Nerve Block
Landmark :
Gingival margin of second and third maxillary molars on palatal side. Mid line of Palate. A point 1 cm away from the palatal Gingival margin toward the mid line of palate.
Mandibular LA Techniques
- Indications of Vazirani Akinosi technique
- Limited mandibular opening
- Multiple procedures on mandibular teeth
- Inability to visualize Landmarks for successful IANB because of large tongue or buccal pad of fat
- Indications of Gow Gates technique
- Multiple procedures on mandibular teeth.
- When buccal soft tissue anesthesia from 3rd molar to midline is necessary.
- When Lingual soft tissue anesthesia is necessary.
