a brief for local anesthesia techniques in dentistry; practical for after perusing the techniques before. Used reference was MALAMED handbook of oral anesthesia.

1. TECHNIQUES OF
LOCAL
ANESTHESIA
In a nutshell
MohammadReza Vatankhah

3. Supraperiosteal injection

5. Posterior Superior Alveolar Nerve
Block
■ High success rate
■ Risk of hematoma
■ Technique somewhat arbitrary: no bony landmarks during insertion
■ Second injection necessary for treatment of the first molar (mesiobuccal root) in 28% of
patients

9. Middle Superior Alveolar Nerve Block
■ Indicated for procedures on premolars and for the mesiobuccal root of the maxillary first
molar.
■ Contraindicated Where the MSA nerve is absent, innervation is through the anterior
superior alveolar (ASA) nerve; branches of the ASA innervating the premolars and
mesiobuccal root of the first molar can be anesthetized by means of the MSA technique
■ the mucobuccal fold above the second premolar
■ No bone touch.

12. Anterior Superior Alveolar Nerve Block
(Infraorbital Nerve Block)
■ Nerves Anesthetized
■ 1. Anterior superior alveolar
■ 2. Middle superior alveolar
■ 3. Infraorbital nerve
– a. Inferior palpebral
– b. Lateral nasal
– c. Superior labial

13. Anterior Superior Alveolar Nerve Block
(Infraorbital Nerve Block)
■ Inflammation or infection (which contraindicates supraperiosteal injection); if a
cellulitis is present, the maxillary nerve block may be indicated in lieu of the
infraorbital nerve block (indicated)
■ Discrete treatment areas (Contra-indicated)
■ Ant to 1st pre.
■ Almost the half of L- needle.

17. Greater Palatine Nerve Block

19. Nasopalatine Nerve Block

20. Anterior Middle Superior Alveolar
Nerve Block (double-tech)

21. Palatal Approach-Anterior Superior
Alveolar

22. Maxillary Nerve Block

24. INFERIOR ALVEOLAR NERVE
BLOCK
■ Landmarks
– a. Coronoid notch (greatest concavity on the anterior border of the ramus)
– b. Pterygomandibular raphe
– c. Occlusal plane of the mandibular posterior teeth
– 2/3 & 3/4

27. BUCCAL NERVE BLOCK

29. ■ Height of injection established by placement of the needle tip just below the
mesiolingual (mesiopalatal) cusp of the maxillary second molar
■ Penetration: just distal to the maxillary second molar

31. VAZIRANI-AKINOSI CLOSED-MOUTH
MANDIBULAR BLOCK

32. MENTAL NERVE BLOCK
■ 1. Soft-tissue biopsies
■ 2. Suturing of soft tissues

35. INCISIVE NERVE BLOCK
■ bilateral incisive nerve blocks can be administered.
■ It is not necessary [also not indicated; according to the text] for the needle to
enter into the mental foramen for an incisive nerve block to be successful.