Chapter 13- Maxillary Pain Control Palatal Approach

it never ends

_____ nerve block injections are indicated for anesthesia of palatal soft and osseous tissue in the anterior third of the palate, approximately from canine to canine.

NP

What is the field of anesthesia for NP?

Palatal soft tissues innervated by the NP nerve bilaterally

Related lingual periodontium

Where is the penetration site for NP?

in the mucosa, lateral to the widest anteroposterior dimension of the incisive papilla

What is the needle pathway for NP?

Under the incisive papilla, through dense mucosal tissues to contact the opposite wall of the incisive canal near its entrance

What is the deposition site for NP?

Near the wall of the incisive canal

How is “pressure” pre-anesthesia administered?

Holding a cotton-tipped applicator or smooth instrument handle against the tissue to minimize needle puncture discomfort

What is the deposition rate of NP?

0.4ml about 13 to seconds

1 minute per cartridge

What is are the key signs when confirming anesthesia for NP?

A sense of numbness of the gingiva on the anterior palate

_______ nerve blocks are indicated for anesthesia of palatal soft and osseous tissues distal to the canine in one quadrant.

GP

What is the field of anesthesia for GP?

Posterior portion of the hard palate and overlying soft tissues

Anteriorly as far as the first premolar and medially to the midline

Where is the penetration site for GP?

Palatal soft tissue slightly anterior to the GP foramen

At the anterior border of the depression of foramen

What is the needle pathway for GP?

Very short, through dense palatal tissue directly to bone

Where is the deposition site for GP?

Anterior to the opening of anterior palatine foramen

What is the deposition rate for GP?

0.4ml over 30 seconds

Approximately one cartridge over 2 minutes

What are the key signs when confirming anesthesia of GP?

An immediate sense of tightness and numbness of gingival and palatal tissues

What are the complications for GP?

Postoperative pain injection site

Rarely, hematoma

Postoperative edema

Risk of necrosis increases with use of 1:50,000 epinephrine

Which one of the following statements best describes the deposition site for a nasopalatine nerve block?

The deposition site is near the wall of the incisive canal.

The most common cause of failure for palatal injection techniques is:

Both of these are correct

The AMSA technique can provide anesthesia for areas traditionally anesthetized by which one of the following groups of injections?

ASA, MSA, NP, and GP

Which one of the following statements is true of NP nerve blocks?

They provide bilateral anesthesia

Which one of the following is an important consideration in all palatal LA procedures?

Always administer solutions slowly

True or False: AMSA nerve blocks provide bilateral anesthesia of palatal tissues at least 20% of the time.

False