Term
Middle Superior Alveolar
"MSA"
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Definition
Area 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: Insert to a point well above apex of second premolar
Amount recommended: ½-2/3 carpule
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Term
Posterior Superior Alveolar
Nerve Block
“PSA”
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Definition
Area 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: Short 25/27 gauge
Angle of insertion: 45 degrees medially toward midsaggital plane
Penetration: Needle tip inserted 16 mm
Amount: ½-2/3 carpule
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Term
Anterior Superior Alveolar
“ASA”
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Definition
Area 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 gauge
Angle of insertion: 25 degrees medially toward bone
Penetration: Variable, needle tip inserted to a point
Amount: 1/3-1/2 carpule
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Term
Greater Palatine
Nerve Block
“GP”
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Definition
Area anesthetized: Hard Palate, overlying tissue from 3rd -1st 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: 4-6 mm, to boney resistance
Amount: 2 – 3 drops or ¼ carpule (tissue will blanch)
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Term
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Definition
Area 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: 1.4-1.8 ml
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Term
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Definition
Area anesthetized: 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
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Term
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Definition
Area 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 gauge
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
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Term
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Definition
Area 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: 5-6 mm
Angle of insertion: 20 degrees to the long axis of premolars, bevel toward bone
Amount: 1/3 carpule
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Term
Infiltration
“Maxilla or Mandible”
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Definition
Area anesthetized: 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: 3-6 mm to the apex
Angel of insertion: 20 degrees to long axis of tooth
Amount: 0.6 ml
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