Nerve Block Anesthesia in Dentistry Xudong Wang,DDS,MD Dept.of Oral Maxillofac Surg. Affiliated Ninth People's Hospital Shanghai Second Medical University 2023716
2023/7/16 Nerve Block Anesthesia in Dentistry Dept. of Oral & Maxillofac Surg. Affiliated Ninth People’s Hospital Shanghai Second Medical University Xudong Wang, DDS,MD
Local Anesthesia >Topical Anesthesia(表面麻醉) >L0 cal Infiltration(局部浸润麻醉) small area anesthetized(one or two teeth) solution deposited near terminal nerve endings g士8, 2 2 extractions >Nerve Block(阻滞麻醉) REVIEW deposited near large nerve trucks 20237116
2023/7/16 Local Anesthesia REVIEW ➢ Topical Anesthesia(表面麻醉) ➢ Local Infiltration( 局部浸润麻醉) • small area anesthetized (one or two teeth) • solution deposited near terminal nerve endings • 8 8 , 2 2 extractions ➢ Nerve Block ( 阻滞麻醉) • deposited near large nerve trucks
Advantages of nerve block Larger analgesia area avoid several injections Less dosage long--lasting Away from the lesion -avoid spreading of infection tumor seeding Less tissue deformity post-injection -plastic surgery >Better Anesthetic Effectiveness 2023716
2023/7/16 Advantages of nerve block ➢ Larger analgesia area & avoid several injections ➢ Less dosage & long--lasting ➢ Away from the lesion -- avoid spreading of infection & tumor seeding ➢ Less tissue deformity post-injection -- plastic surgery ➢ Better Anesthetic Effectiveness
Anatomy of Trigeminal Nerve 三叉神经 Ophthalmic Nerve Maxillary Nerve Mandibular Nerve 20237/16
2023/7/16 ➢ Ophthalmic Nerve ➢ Maxillary Nerve ➢ Mandibular Nerve Anatomy of Trigeminal Nerve (三叉神经)
Nerve Block Anesthesia Maxillary Nerve Anesthesia Posterior superior alveolar block(上牙槽后神经) Buccal 飞Infraorbital block(眶下神经) Palatal Greater palatine block(腭大神经) Nasopalatine block(鼻腭神经) Less dense bone/less anatomic variation Mandibular Nerve Anesthesia 20237116
2023/7/16 ➢ Maxillary Nerve Anesthesia Posterior superior alveolar block（上牙槽后神经） Infraorbital block (眶下神经） Greater palatine block （腭大神经） Nasopalatine block（鼻腭神经） Less dense bone/ less anatomic variation ➢ Mandibular Nerve Anesthesia Nerve Block Anesthesia { { Buccal Palatal
Posterior Superior Alveolar Block PSA Block上牙槽后神经阻滞， Tuberosity Injection.上颌结节注射法) >Spread of analgesia麻醉范围 876678 (mesiobuccal root) Pulp alveolar process Buccal -gingiva(牙龈) -periodontium(牙周膜) -periosteum(骨膜) 2023716
2023/7/16 Posterior Superior Alveolar Block (PSA Block 上牙槽后神经阻滞, Tuberosity Injection上颌结节注射法) ➢ Spread of analgesia 麻醉范围 876 678 Pulp & alveolar process Buccal - gingiva(牙龈) - periodontium (牙周膜) - periosteum (骨膜) (mesiobuccal root)
Posterior Superior Alveolar Block (PSA Block) Target area Injection site 77 distal apex Angulation Mucobuccal fold 20237/16
2023/7/16 Posterior Superior Alveolar Block (PSA Block) ➢ Injection site 7 7 distal apex Mucobuccal fold ➢ Angulation ➢ Target area
Posterior Superior Alveolar Block (PSA Block) Depth of penetration terygoid plexus( Average adult 16-20 mm Small adult and children 14mm >Aspiration回抽) Injection amount 1.5-2ml Hematoma(血肿) Time to effect 5-10 min 20237116
2023/7/16 Posterior Superior Alveolar Block (PSA Block) ➢ Depth of penetration Average adult 16-20 mm Small adult and children 14mm 1.5-2ml ➢ Injection amount Pterygoid plexus(翼丛) ➢ Time to effect 5-10 min ➢ Aspiration(回抽) Hematoma(血肿)
Posterior Superior Alveolar Block 20237116
2023/7/16 Posterior Superior Alveolar Block