Middle superior alveolar MSA

Teeth anesthetized: Maxillary premolars and mesiobuccal root of first molar

Penetration site: height of mucobuccal fold above second premolar

Landmarks: Height of mucobuccal fold

Length of needle: short 25/27 gauge

Angle of insertion: 20 degrees medially toward bone

Penetration: inserted to a point well above apex of second premolar

Amount recommended: ½-2/3 carpule

Posterior superior alveolar nerve blocks

PSA

Teeth anesthetized: maxillary molars except mesiobuccal root of first molar

Penetration Site: height of mucobuccal fold

Landmarks: Height of mucobuccal fold above second molar, maxillary tuberosity

Length of needle: 25/27

Angle of insertion: 45 degrees

Penetration: needle tip inserted 16mm

Amount: ½-2/3 carpule

Anterior superior alveolar

ASA

Teeth anesthetized: canine, lateral, central

Penetration site: height of mucobuccal fold above the canine

Landmarks: mucobuccal fold, canine eminence, fossa mesial to canine

Length of needle: short 25/27

Angle of insertion: 25 degrees medially toward bone

Penetration: Variable, needle tip inserted to a point

Amount: 1/3-1/2 carpule

Greater palatine nerve block

GP

Teeth anesthetized:

Hard Palate, overlying tissue from 3^rd -1^st premolar

Penetration Site: Greater palatine foramen

Landmarks:  Greater palatine foramen, fossa/2nd molar palatal root, tissue indentation from pressure anesthesia

Length of needle: extra short or short 30/27 gauge

Angle of insertion: from opposite side of mouth at right angle to target area bevel toward palate

Penetration: 4-6mm, to boney resistance

Amount: 2 – 3 drops/ ¼ carpule (tissue will blanch)

NP (PASA)

Teeth anesthetized: central, lateral, canine

Penetration site: just lateral to incisive papilla, block; center of papilla on midline

Landmarks: beneath incisive papilla

Length of needle: extra short or short 27/30 gauge

Angle of insertion: approach at 45 degree angle bevel toward palate

Penetration: 6-10mm

Amount: 1.4-1.8ml

Buccal Nerve Block

Teeth anesthetized: none, periodontium on the buccal of molars

Penetration site: Mucous membrane distal and lateral to most posterior molar

Landmarks: Mandibular molars, retromolar pad, vestibule

Length of needle: short when given alone 25/27 gauge Lone when given following an IA

Angle of insertion: syringe parallel to the occlusal plane, lateral to teeth, bevel toward bone

Penetration: greater than or equal to 4mm

Amount: 1/8 carpule

Inferior alveolar

IA

Teeth anesthetized: all teeth in quadrant

Penetration site: medial to internal oblique ridge, lateral to pterygomandibular raphe, at or above height of coronoid notch

Landmarks: Coronoid Notch; occlusal plane, pterygomandibular triangle, and the pterygomandibular raphe

Length of needle: long 25/27

Angle of insertion: 2/3-3/4 length of needle until contact with bone

Penetration: 2/3-3/4 length of needle until contact with bone

Amount: ½ - 1 full carpule

Mental M

Teeth Anesthetized: pulpal limited to tooth, soft tissue located anterior to the mental foramen

Penetration site: mucobuccal fold at or just anterior to mental foramen, varies with each person

Landmarks: mental foramen, located between the apices of the first and second premolars

Length of needle: short 25/27 gauge

Penetration: 5-6mm

Angle of insertion: 20 degrees to the long axis of premolars, bevel toward bone

Amount: 1/3 carpule

Infiltration (mandible)

Teeth anesthetized: at injection site

Penetration site: Mucobuccal fold to tooth

Landmarks: Muccobuccal fold to tooth

Length of needle: extra short or short 25/27/30 gauge

Penetration: 3-6mm to the apex

Angel of insertion: 20 degrees to long axis of tooth

Amount: 0.6ml