Local Anesthesia

Front 1

PSA=

Back 1

Posterior Superior Alveolar Nerve

Front 2

MSA=

Back 2

Middle Superior Alveolar Nerve

Front 3

ASA=

Back 3

Anterior Superior Alveolar Nerve

Front 4

Administration Technique:
Locate foramen with index finger. Pull tissue laterally. Advance needle to level of foramen (5-6mm)
ASPIRATE!

Back 4

Incisive

Front 5

Administration Technique:
Syringe parallel & buccal to occlusal plane of molars on side of injection
ASPIRATE!

Back 5

Buccal

Front 6

Administration Technique:
Upward 45" to occlusal plane. Inward & backward. 45" to midsaggital plane. ASPIRATE 2-3X

Back 6

PSA

Front 7

Administration Technique:
Parallel to long axis of max 2nd bicuspid above the apex. ASPIRATE!

Back 7

MSA

Front 8

Administration Technique:
Angle needle from lateral toward the bone above the cuspid. ASPIRATE!

Back 8

ASA

Front 9

Administration Technique:
45"-00" to tissue at edge of incisive papilla. Watch for blanching of tissue. ASPIRATE!

Back 9

Nasopalatine

Front 10

Administration Technique:
Advance Syringe from opposite side of mouth at right angle to target area. Use pressure anesthesia, topical & swab. ASPIRATE!

Back 10

Greater Palatine

Front 11

Administration Technique:
Palpate sulcus with Q-tip, find soft spot (aprox 3/4 to 2/3of the way into sulcus) Needle hugs raphe. Syringe barrel rests on bicuspids on opposite side of mouth. ASPIRATE!

Back 11

IA (Inferior Alveolar)

Front 12

Administration Technique:
Same As IA deposit on entry or retraction of needle. ASPIRATE!

Back 12

Lingual

Front 13

Local Anesthetic:
Teeth:
None

Back 13

Nasopalatine
Greater Palatine
Lingual
Buccal

Front 14

Local Anesthetic:
Teeth:
Pulpal anes. of 3rd, 2nd & 1st Max Molars except the mesiobuccal root of Max 1st Molar.

Back 14

PSA

Front 15

Local Anesthetic:
Teeth:
Pulpal of 1st & 2nd Max bicuspids & MB root Max 1st molar

Back 15

MSA

Front 16

Local Anesthetic:
Teeth:
Pulpal anes. of Max. Central lateral and cuspid.

Back 16

ASA

Front 17

Local Anesthetic:
Teeth:
Mandibular teeth to mid line

Back 17

Inferior Alveolar (IA)

Front 18

Local Anesthetic:
Teeth:
2nd bicuspid to central

Back 18

Incisive

Front 19

Local Anesthetic:
Gingiva:
Buccal periodontium & bone overlying these teeth

Back 19

PSA

Front 20

Local Anesthetic:
Gingiva:
Facial periodontal tissue and bone over same teeth

Back 20

MSA

Front 21

Local Anesthetic:
Gingiva:
Facial periodontium & bone overlying these teeth.

Back 21

ASA

Front 22

Local Anesthetic:
Gingiva:
Anterior 1/3 of hard palate. Hard & Soft palate tissue cuspid to cuspid

Back 22

Nasopalatine

Front 23

Local Anesthetic:
Gingiva:
Posterior 2/3 of palate & its overlying soft tissues 1st bicuspid & posterior midline

Back 23

Greater Palatine

Front 24

Local Anesthetic:
Gingiva:
Buccal Periostuem to midline gingiva premolars to midline

Back 24

Inferior Alveolar (IA)

Front 25

Local Anesthetic:
Gingiva:
Anterior 2/3 tongue. Floor of oral cavity & lingual soft tissue and periosteum.

Back 25

Lingual

Front 26

Local Anesthetic:
Gingiva:
Soft tissue buccal to mandibular molars (2nd bi and 1st molar)

Back 26

Buccal

Front 27

Local Anesthetic:
Gingiva:
Buccal mucoperiosteum and gingiva. 2nd bicuspid to central lower lip, skin of chin

Back 27

Incisive

Front 28

Anesthetic Solution:
1/2 to 3/4 carpule. 25-Short

Back 28

PSA

Front 29

Anesthetic Solution:
1/2 Carpule Needle short 25-27
1.
2.

Back 29

1. MSA
2. Incisive

Front 30

Anesthetic Solution:
1/2 to 1/3 Carpule Needle short 25-27

Back 30

ASA

Front 31

Anesthetic Solution:
1/8 carpule or until tissue blanches, needle 27 short

Back 31

Nasopalatine

Front 32

Anesthetic Solution:
1/8 carpule or until tissue blanches, needle 25 long

Back 32

Greater Palatine

Front 33

Anesthetic Solution:
2/3 to 3/4 carpule, needle
25 long (1/2-3/4 in depth)

Back 33

Inferior Alveolar (IA)

Front 34

Anesthetic Solution:
1/8 carpule, Needle 25 long
1.
2.

Back 34

1. Lingual
2. Buccal

Front 35

Adverse Effects:
Bad Taste

Back 35

Greater Palatine

Front 36

Adverse Effects:
Needle inserted too far posterior and superior may tear max. artery or pterygoid plexus of veins resulting in Hemastoma

Back 36

PSA

Front 37

Adverse Effects:
Pain from injecting too close to periosteum or too rapid deposition

Back 37

MSA

Front 38

Adverse Effects:
Scrape periosteum from injecting too close to periosteum or too rapidly

Back 38

ASA

Front 39

Adverse Effects:
Pain from injecting into incisive foramen

Back 39

Nasopalatine

Front 40

Adverse Effects:
Hematoma of inferior alveolar artery. Trismus of muscles. too far posterior parotid gland which facial nerve innervates-can't close eyes.

Back 40

Inferior Alveolar (IA)

Front 41

Adverse Effects:
"Shocking" Pain if lingual nerve is touched

Back 41

Lingual

Front 42

Adverse Effects:
Trismus of tendonous attachment of temporalis, Ballooning of tissues.

Back 42

Buccal

Front 43

Adverse Effects:
Few & extremely rare Hematoma, burning sensation.

Back 43

Incisive

Front 44

Landmarks:
Base of mucobuccal fold, distal to 2nd bicuspid

Back 44

Incisive

Front 45

Landmarks:
External oblique ridge. Mandibular molars

Back 45

Buccal

Front 46

Landmarks:
Coronoid notch, internal oblique ridge. Pterygomandibular raphae, sulcus.
1.
2.

Back 46

1. IA
2. Lingual

Front 47

Landmarks:
Halfway between free gingival margin & midline of palate. Anterior to soft palate between 1st and 2nd molars, 40% of population has depression

Back 47

Greater Palatine

Front 48

Landmarks:
Maxillary central incisors, incisive papillae

Back 48

Nasopalatine

Front 49

Landmarks:
Mucobuccal fold, maxillary lateral fossa above lateral

Back 49

ASA

Front 50

Landmarks:
Mucobuccal fold.
Maxillary second bicuspid
Zygomatic Process

Back 50

MSA

Front 51

Landmarks:
Mucobuccal fold
zygomatic. Process of maxillary tuberosity, 2nd maxillary molar.

Back 51

PSA

Front 52

Injection Site:
Height of Mucobuccal fold. Distal root of 2nd molar

Back 52

PSA

Front 53

Injection Site:
Height of Mucobuccal fold above apex of Maxillary 2nd bicuspid.

Back 53

MSA

Front 54

Injection Site:
Height of Mucobuccal fold. Mesial to root of cuspid, above lateral in lateral fossa.

Back 54

ASA

Front 55

Injection Site:
Either side of incisive papilla

Back 55

Nasopalatine

Front 56

Injection Site:
Soft tissue slightly anterior to greater palatine foramen

Back 56

Greater Palatine

Front 57

Injection Site:
Center of ptergomandibular triangle: medial border is pterygomandibular raphae. Lateral border is internal oblique ridge. Root is tendonous attachment of temporalis.

1.
2.

Back 57

1. Inferior Alveolar (IA)
2. Lingual

Front 58

Injection Site:
Penetrate 1 cm above occlusal plane between internal and external ridges.

Back 58

Buccal

Front 59

Injection Site:
Mucobuccal fold just posterior to mental foramen

Back 59

Incisive

Front 60

Deposit Location:
Check on radiograph for mental foramen, advance to penetration (5-6mm)

Back 60

Incisive

Front 61

Deposit Location:
Penetrate mucous membrane until bone is contacted

Back 61

Buccal

Front 62

Deposit Location:
Retract needle halfway from depth of IA injection

Back 62

Lingual

Front 63

Deposit Location:
Penetrate mucous membrane until bone is contacted

Back 63

Inferior Alveolar (IA)

Front 64

Deposit Location:
At junction of vertical and horizontal planes of hard palate 5-7 mm or about 1/6 deep.

Back 64

Greater palatine

Front 65

Deposit Location:
Through tissue next to incisive papilla about 3-5 mm deep

Back 65

Nasopalatine

Front 66

Deposit Location:
Penetrate mucous membrane over lateral fossa angle to apex of cuspid

Back 66

ASA

Front 67

Deposit Location:
Penetrate mucous membrane, advance needle until tip is located above apex of 2nd bicuspid (1/4 to 1/2 in deep)

Back 67

MSA

Front 68

Deposit Location:
In vicinity of forament of PSA nerve. Through soft tissue. Needle penetrating 1/2 to 3/4 in deep apex of 3rd molar.

Back 68

PSA