Posterior Superior Alveolar Nerve Block

* Anatomical Landmarks:

  • Mucobuccal fold
  • Zygomatic process of the maxilla
  • Infratemporal surface of maxilla
  • Anterior border and coronoid process of the     Ramus of the mandible
  • Maxilalry Tuberosity

 * Nerves Anesthetized:

   - Posterior Superior Alveolar Nerve and its branches

* Areas Anethetized:

  - Pulpal anesthesia of maxillary 1st,2nd and 3rd molars ( except mesiobuccal root of
    maxillary 1st molar)
 -  Buccal mucoperiosteum and bone overlying these teeth

  * Technique for Posterior Superior Alveolar Nerve block:

 • patient position:-  the back rest of the dental  chair is tilted to a 45 degree angle to the
   floor, this helps to keep the  occlusal plane of the patient at degrees when the patient  
   opens  his/her  mouth.
  • operator position:- 10 o'clock position
  • area of insertion :- muccobuccal fold above  the  mesial cusp of the second molar.
  • bevel of needle :- towards the bone
  • procedure :- needle is inserted at the area of insertion nd give a upward,  backward nd  
                          inward rotation of the needle.
                        - see for the two negative aspiration
                        - inject a 0.9 to 1.8 ml of L.A
                        - wait for 2 minutes and check for the subjective nd objectiv signs.

* Amount of L.A :- 0.9 to 1.8 ml

* subjective nd objetive signs :-
   - objective signs : instrumentation done with the use either with the tip of blunt    
                                  probe or elevator to check for objective  symptoms.
                                • The aneathetized tissue nd tooth to be pressed and tapped as compared
                                   to the un-anesthetized tissues.
  - subjective signs : we cannot find any particular subjective signs.