Maxillary Infiltration Technique ( infiltration vs block)

Bismillah..

Kita masih lagi bercakap taju yg sama iaitu maxillary infiltration technique.

cuma kali ini kita ini tak guna infiltration. Kita guna block

Persoalannya..bila masa kita nak guna maxillary block ni?will not work

>Bila mana ada local imflammatory abscess..so local infiltration disebabkan byk faktor..anataranya acidic environment.

jadi kita guna block anesthesia kat kawasan yang distal to tooth atau in large procedures.

Supra periosteal infiltration injection.

Nerve anesthesized: large terminal branch of dental plexus.

Area anesthesized: pulp and root area of buccal periosteum, connective tissue and mucus membrane

Area of insertion: height of the mucobuccal fold (mucogingival junction) above the apex of the tooth anesthesized> buccal or slightly distal to the apex of the tooth so it will anesthesize it.

cukup ke kalau buat pulpal anesthesia?
> kalau buat anesthesia utk extraction, kena infiltrate both sides bucally and palatally
> kalau buat conservative treatmen: buccal infiltration cukup je sbb dia akan bagi pulpal anesthesia
> kalau utk central incisor: boleh jadi yes or no..sbb? ada sesetengah kes,, you dont get good pulpal anesthesia after bone infiltration, kena buat infiltration kat opposite CI

Maxillary block anesthesia

either we give to

1. maxillary nerve
2. posterior superior alveolar nerve
3. middle SAN
4. ant SAN
5. infraorbital nerve 
6. palatal nerve (nasopalatine posteriorly and greater palatine anteriorly)

Post SAN block

-innervates roots of max 7 &8 and distal and mesiobuccal root of upper 6

-area of insertion: height of the mucobuccal fold between first and second molars.  

-angle of insertion: 45 degree upward and backward (1-1.5cm) so you will not get a bony contact.

-we insert it a little bit medially, then we inject 1 carpule to get anesthesia of post SAN

-insert about 15-20mm

penting nak kena study pasal anatomy ni. contohnya kalau kat post SAN if you insert 2cm instead of 1 cm so you will anesthesize whole maxillary nerve.

you may anesthesize the branch only or the main trunk by controlling the insertion

Middle SAN block

- anesthesize maxillary premolars and mesiobuccal root of upper 6, corresponding alveolus and buccal gingival tissue

-ada kat 28% population. kalau xde ni maknanya teeth are innervated by ant SAN

-area of insertion: height of mucobuccal fold between first and second premolar. sama macam infiltration tapi a little bit higher.

-insert about: 10-15 mm

-inject around: 0.9-1.2 cc

kdg2 bila kita infiltrate upper 4, upper 5 is anesthesized. Ini disebabkan infiltration and block in the same area.

kalau kita buat infiltration to the middle SAN and it didnt work so kita buat infraorbital block. this means that the middle superior alveloar is absent.

Ant SAN block.

used to anesthesize max canine, LI, CI, alveolus and buccal gingiva.

area of insertion: height of mcobuccal fold in area of LI and canine> distal aspect of LI.