Compare local infiltration with nerve block local anesthesia.

Local infiltration anesthetizes a small area including one or 2 teeth and tissues. Varying degrees of success. deposited near apicies

Nerve Block affects a larger area. deposited near large nerve. More success

Compare the effectiveness of maxillary anesthesia with the effectiveness of mandibular anesthesia.

How effective is local infiltration in the maxillary?

PSA block

Area anesthetized? Target area and injection site? Symptoms and possible complications? How do you avoid complications?

1. 1st, 2nd and 3rd molar (mesio buccal root sometimes reached when MSA given)

2. target is PSA nerve. Injection site is apex of max 2nd molar 45°

3. Symptoms - dull feeling teeth. Complications: hematoma from hitting dental plexus.

4. Aspirate

MSA block  

Area anesthetized? Target area and injection site?

Symptoms and possible complications?

1. Maxillary premolars and mesiobuccal root of maxillary 1st molar and buccal tissues.

2. Target area is MSA nerve. Injection site is apical to max 2nd premolar.

3. tingling in upper lip. Complications: overinsertion. Rare hematoma.

ASA block

Area anesthetized? Target area and injection site? Symptoms and possible complications?

1. Incisor and Maxillary Canine and buccal tissues

2. ASA Nerve. Injection Apex of Max Canine.

3. numbness of upper lip. Complications: Rare Hematoma

IO block  

Area anesthetized? Target area and injection site?Symptoms and possible complications?

1. Maxillary premolar, canine, and incisors

2. Target: ASA and MSA nerve. Injection: Maxillary 1st premolar up to infraorbital foramen

3. numbness of eyelid and side of nose, and upper lip. rare hematoma under eye

GP block

Area anesthetized? Target area and injection site? Discuss the use of pressure anesthesia on the hard tissues of the palate. Symptoms and possible complications?

1. Posterior portion of the hard palate.

2. anterior to where gp nerve enters. Injection: anterior to depression made by greater palatine foramen

3. Pressure use creates dull ache that blocks pain from needle

4. numbness of posterior palate. Patients may gag if soft palate is anesthetized.

NP block

Area anesthetized? Target area and injection site? Discuss the use of pressure anesthesia on the hard tissues of the palate. Symptoms and possible complications?

1. hard palate from 1st premolar to 1st premolar.

2. Right and left NP nerves. injection site: incisive foramen.

3. pressure blocks pain from needle.

4. numbness of anterior palate. Hematoma is rare

AMSA block

 Area anesthetized? Target area and injection site? Discuss the use of pressure anesthesia on the hard tissues of the palate. Symptoms and possible complications?

1. 2nd premolar through central incisor.

2. Tissues of the hard palate. Injection: Midway between median palatal sutures and max premolars.

3. Pressure reduces pain.

4. Blanching occurs after given injection can cause postoperative ischemia and sloughing. slow injection can stop that.

Compare the effectiveness of mandibular injections with the effectiveness of maxillary injections.

How effective is an infiltration in the mandible? What portion of the mandible is more effective using infiltration?

IA block

Area anesthetized?Are bilateral injections advisable? Target area and injection site? Symptoms and possible complications? How do you avoid complications?

1. Entire quad including lingual tissues and buccal except for molar region

2. No  3. superior to IA nerve into mandibular foramen. Injection: Medial border of the mandibular ramus.

4. numbness of lower lip. tingling of tongue and floor of the mouth. lingual shock or facial paralysis. Parasthesia.

5. make sure you hit the bone if not pull out and reinject.

Discuss troubleshooting the IA block depending on the contact of the needle with the bone.What is the accessory innervation that can prevent a successful IA block?

Buccal block

Area anesthetized? Target area and injection site? Symptoms and possible complications?

1. buccal gingiva.

2. buccal nerve injection: distal to last molar in arch.

3.no symptoms complications: cheek bites and rare hematoma.

Mental block

Area anesthetized? Target area and injection site? Symptoms and possible complications?

1. facial gingiva premolar forward.

2. mental nerve inject: near mental foramen.

3. numbness lower lip. Rare hematoma

Incisive block

Area anesthetized? Target area and injection site? Symptoms and possible complications?

1. 2nd mand Premolar to central incisor and buccal tissue.

2.  mental nerve. Mental foramen. between 1st and 2nd premolar

same as mental block only rubbed in hole foramen to get teeth.

3. numbness of lower lip hematoma rarely occurs

Gow-Gates mandibular block

 Area anesthetized? Reasons for use?

Target area and injection site? Symptoms and possible complications?

1. one whole quad lingual and buccal. 2. quadrant dentistry

3. anteromedial border of condylar neck. Injection: mesial on mandibular ramus.

4. lower lip and temporal area numb. Longer time to kick in but lasts longer. Cant do in patients with limited open mouth ability

IO

Where and what teeth does it cover?

PSA

Where good for?

MSA

where good for?

ASA

Where good for?