Posterior and Superior Alveolar Block
By Alexia Giapisikoglou


Posterior Superior Alveolar
• arise from the trunk of the maxillary nerve just before it enters the infraorbital groove
•Technique:
• - area of insertion is at the height of the mucobuccal fold b/n 1st and 2nd molar
-Angle at 45° superiorly and medially
-No resistance should be felt
-Insert about 15-20mm
-ALWAYS aspirate
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Middle Superior Alveolar
• involves pulpal anesthesia of first and second premolars and mesiobuccal root of first molar,
buccal soft tissues and bone over same teeth
•Indications:
-Anesthesia of maxillary premolars and
-Infraorbital nerve block failure
• Contraindications:
-Inflammation in the area
-MSA is present only 28%  of time

Middle Superior Alveolar
• Technique:
•- between first and second premolar
• -ALWAYS aspirate
•

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Complications
• hematoma (= is a localized collection of blood outside the blood vessels) •Positive aspiration
(need to remove the needle and try again)
•

Abscesses
•= exudate enclosed in the tissues of the jaw bone at the apex of the infected tooth’s root
•Originates: from bacterial infection that has accumulated in soft, usually dead, dental pulp (eg.
Failed root canal treatment)
•Symptoms: 1.continuous pain,
•                         2.affected tooth by pressure
•                         3. or diff. in temperatures
•                         4. may perforate bone and create local facial swelling

Abscesses
•TYPES:
-Gingival abscess: involves only gum tissue
-Periapical abscess: starts at apex of root
-Periodontal abscess: starts in pocket of gingiva over 3mm
•
•TREATMENT:  use of antibiotics  and if the tooth can be restored root canal therapy should be
performed
•
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jpg

Infection of maxillary sinus
•The sinuses are composed of air: when swollen, the increased pressure in the sinus cavity => pain
•    when inflammation => difficult to breath from nose
•origin: virus, bacteria, inflammation
•Symptoms: toothache, migraines, feelings of pressure, fever, swelling around the eye