Maxillary Injection Technique

Bismillah..

Seperti yang kita tahu utk beri bius pada orang ni bukan senang.Dentist memang kena kuasai nerve (urat) lagi2 yang dekat muka dengan kepala. Kalau tersalah nerve boleh menyebabkan patient merana seumur hidup..naudzubillah

doakan aku agar aku boleh menguasai ilmu dgn baik ;)

Selalu technique yang kita pakai untuk maxilla ni infitration..tapi boleh je kalau nak pakai block anesthesia pun.

First and foremost mesti kena tahu tentang anatomy dulu.

Trigeminal nerve

ha itula trigeminal nerve. Kira nerve besar jugakla..sbb ada 3 branches.

V1: Opthlamic division (sensory)
V2: Maxillary division (sensory)
V3:  Mandibular division (motor and sensory)

V2: Maxillary division

exit melalui foramen rotundum of greater wing of sphenoid

Branches: divided by location.

1) intercranial: within cranium ( before getting out from foramen rotundum).
.middle meningeal nerve- providing sensory innervation to the dura matter

2) pterygopalatine  ( within pterygopalatine fossa)
a-Zygomatic nerve

zygomaticofacial nerve- skin to cheek prominence
zygomaticotemporal nerve- skin to lateral forehead

b-pterygopalatine nerve: serve as communication for the pterygopalatine ganglion and the maxillary nerve. Carry postganglionic secretomotor fibers through the zygomatic branch to the lacrimal gland.

orbital branch: supply periosteum of the orbits.
nasal branch: supply mucous membranes of superior and middle conchae, lining of posterior ethmoid sinuses and posterior nasal septum.

Nasopalatine nerve: travels across the roof of nasal cavity giving branches off to the anterior nasal septum dan floor of nose. Enters incisive foramen and provides palatal gingival innervation of premaxilla.

Palatine branches: greater (ant) and lesser (middle or post) palatine nerves

Greater palatine: travels through the pterygopalatine canal , enters the palate via greater palatine foramen. Innervates palatal tissue from premolars to soft palate.

Lesser palatine: merges from lesser palatine foramen and innervates the mucous membranes of soft palate and parts of tonsillar region.

Pharyngeal branch: exits the pterygopalatine ganglion and travels through the pharyngeal canal. Innervates mucosa of the portions of nasal pharynx

Nerve paling penting: Nasopalalatine, greater palatine and lesser palatine..sbb apa?

they innervate the palate. boleh buat sama ada guna infiltration or block.

c)Post sup alveolar nerves.

into infraorbital groove- innervates molars

infraorbital (within the infraorbital fissure)

infraorbital branch: middle, anterior

middle: innervates premolars

anterior: ant teeth

branches from 6-8 mm posterior to the infraorbital nerve exit from infraorbital foramen.

facial: emerge from infraorbital foramen

inferior palpebral: lower eyelid
external nasal: lateral skin of the nose
superior labial branch: upper lip skin and mucosa