Injections for Palatal Pain Control

What is anesthetized by the NP

palatal to incisors and canines

What is anesthetized by the GP

palatal tissue of posterior teeth

Why would a NP nerve block be used

anesthesia of palatal soft and anterior third of the palate osseous tissue in the, approximately from canine to canine

What needle is used for NP

27 Ga short

What is the penetration site for a NP

In the mucosa, lateral to the widest anteroposterior dimension of the incisive papilla (at its base)

What is the needle pathway for a NP

Under the incisive papilla 3-5mm through dense mucosal tissues until bone is gently contacted or the needle tip is well beneath the mucosa

What is the deposition site for an NP

The deposition site is near the wall of the incisive canal

What is pressure pre-anesthesia

when local anesthesia is administered by holding a cotton-tipped applicator or smooth instrument handle against the tissues to minimize needle puncture discomfort; produces a decrease in sensitivity due to temporary anoxia

What is the penetration depth of an NP

3-5mm for infiltration

6-10mm for block

What is the deposition of an NP

Significantly slower standard rate

-0.4 ml over 40 seconds

How much anesthetic should be used in NP

1/8 of the cartridge

What is the alternatives for an NP

multiple infiltrations

What are common causes of injection failure in NP

Inadequate depth of penetration

Inadequate volume of solution

Overlapping innervation by the GP nerve

Inflammation

Infection

Inadequate diffusion

What complications can come from an NP

a risk of necrosis

NEVER use 1:50,000 epinephrine!

What is a GP used for

anesthesia of palatal soft and osseous tissues distal to the canine in one quadrant

Where is penetration site for a GP

Palatal soft tissue slightly anterior to the GP foramen

At anterior border of depression of foramen

What is the needle pathway for a GP

very short pathway (4-6mm or <10mm)

through dense palatal tissue directly to bone

What is the deposition site for a GP

Anterior to opening of greater (anterior) palatine foramen

What is the needle selection for the GP

27 Ga short

How much anesthetic will be used in a GP

1/4-1/3 of the cartridge