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NERVE BLOCKSNERVE BLOCKS
INDIAN DENTAL ACADEMY
Leader in continuing dental education www.indiandentalacademy.com
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Greater Palatine Nerve Greater Palatine Nerve BlockBlock
Anterior palatine nerve blockAnterior palatine nerve block
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ANATOMICAL LANDMARKSANATOMICAL LANDMARKS
Maxillary 2Maxillary 2ndnd & 3 & 3rdrd molars molars Palatal gingival margins of the Palatal gingival margins of the
molarsmolars Midline of the palateMidline of the palate Line approx 1cm from palatal Line approx 1cm from palatal
margin towards the midlinemargin towards the midline
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INDICATIONSINDICATIONS
Palatal Anesthesia in Palatal Anesthesia in conjunction with PSA or MSA conjunction with PSA or MSA BlocksBlocks
Surgery-Posterior palateSurgery-Posterior palate
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AREAS ANESTHETIZEDAREAS ANESTHETIZED
Palatal Gingiva & Post portion of Palatal Gingiva & Post portion of Hard PalateHard Palate
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TECHNIQUETECHNIQUE
Approach –Opposite sideApproach –Opposite side 1 inch, 25 gauge needle1 inch, 25 gauge needle Right angle to the curvature of Right angle to the curvature of
palatal bone.palatal bone. Anesthetic solution- 0.25 to Anesthetic solution- 0.25 to
0.5ml- injected slowly0.5ml- injected slowly
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SYMPTOMSSYMPTOMS
Subjective-Numbness on Subjective-Numbness on contact with tonguecontact with tongue
Objective-absence of pain Objective-absence of pain sensationsensation
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ADVANTAGESADVANTAGES
Deposition of solution anterior to Deposition of solution anterior to the foramen.the foramen.
Dual innervation.Dual innervation.
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COMPLICATIONSCOMPLICATIONS
Palatal ischemiaPalatal ischemia
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NASOPALATINE NASOPALATINE NERVE BLOCKNERVE BLOCK
Incisive nerve blockIncisive nerve block
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ANATOMICAL LANDMARKSANATOMICAL LANDMARKS
Central incisor teethCentral incisor teeth Incisive papillaIncisive papilla
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INDICATIONSINDICATIONS
Supplement for Anterior and Supplement for Anterior and Middle superior alveolar nervesMiddle superior alveolar nerves
Analgesia for maxillary anteriorsAnalgesia for maxillary anteriors Anesthesia of nasal septumAnesthesia of nasal septum
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AREAS ANESTHETIZEDAREAS ANESTHETIZED
Anterior portion of the hard Anterior portion of the hard palatepalate
Palatal gingival tissue of six Palatal gingival tissue of six anterior teethanterior teeth
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TECHNIQUETECHNIQUE
Extremely painful- preparatory Extremely painful- preparatory injection is made by inserting injection is made by inserting 1inch, 25 gauge needle into the 1inch, 25 gauge needle into the labial inter-septal tissue labial inter-septal tissue between maxillary central between maxillary central incisors and 0.25ml of solution is incisors and 0.25ml of solution is deposited.deposited.
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TECHNIQUETECHNIQUE
Needle inserted slowly into crest Needle inserted slowly into crest of papillaof papilla
Advanced into the incisive Advanced into the incisive foramen, 0.5cm into the canal.foramen, 0.5cm into the canal.
0.25-0.5ml solution injected 0.25-0.5ml solution injected slowly to prevent distention of slowly to prevent distention of surrounding tissuesurrounding tissue
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SYMPTOMSSYMPTOMS
Subjective-feeling of Numbness Subjective-feeling of Numbness on contact with palateon contact with palate
Objective-Absence of pain on Objective-Absence of pain on instrumentation instrumentation
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COMPLICATIONSCOMPLICATIONS
Palatal soft tissue necrosisPalatal soft tissue necrosis
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Thank youThank you
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