PALATAL ANESTHESIA

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PALATAL ANESTHESIA
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Greater Palatine Nerve Block

• Anterior Palatine Nerve
• Posterior portion of hard palate and
  overlying soft tissues
• Anteriorly to 1st premolar
• Medially to midline

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Greater Palatine Nerve Block

• Indications
• Pain control in posterior palatal hard and/or
  soft tissues
• Contraindications
• Inflammation / infection at injection site
• Only small area necessary (eg. 1-2 teeth)

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Greater Palatine Nerve Block

• Advantages
• Minimizes penetrations and discomfort
• Minimizes volume of solution (0.5 ml)
• Disadvantages
• Limited hemostasis
• Potentially traumatic

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Greater Palatine Nerve Block

• Alternatives
• Local infiltration in each area
• Maxillary Nerve Block
• Aspiration
• lt 1 positive

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Greater Palatine Nerve Block

• Landmarks
• Greater palatine foramen
• Junction of alveolus and palatine bone
• Area of Insertion
• Soft tissue anterior to foramen, from
  opposite side

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Greater Palatine Nerve Block

• Precautions
• Do not enter canal
• Signs symptoms
• Numb posterior palate painfree treatment
• Safety features
• Bone contacted aspiration

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Greater Palatine Nerve Block

• Technique
• Position - open wide, extend turn head
• Cotton swab - identify landmarks, topical
• Approach - bevel to tissue, advance to bone
• Aspirate inject 0.5 ml slowly

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Greater Palatine Nerve Block

• Failure
• Overlap of fibers from Nasopalatine nerve
• Injection too anterior
• Complications
• Soft tissue ischemia / necrosis
• Post injection pain, hematoma

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NASOPALATINE NERVE BLOCK
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Nasopalatine Nerve Block

• Indications
• Pain control in anterior hard and/or soft
  tissues
• Contraindications
• Inflammation / infection at injection site
• Only small area necessary (eg. 1-2 teeth)

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Nasopalatine Nerve Block

• Advantages
• Minimizes needle penetrations
• Minimizes volume of solution (0.4 ml)
• Disadvantages
• Limited hemostasis
• Potentially traumatic

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Nasopalatine Nerve Block

• Alternatives
• Local infiltration
• Maxillary Nerve Block
• Aspiration
• lt 1 positive

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Nasopalatine Nerve Block

• Precautions
• Do not inject directly into papilla/canal
• Inject slowly, with small volume
• Signs / symptoms
• Numb anterior palate painfree treatment
• Safety features
• Bone contacted aspiration

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Nasopalatine Nerve Block

• Technique
• Position - open wide, extend head
• Landmarks - incisive papilla, central
  incisors
• Approach - lateral to incisive papilla,
  starting with cotton swab, topical
• Deposit approx. 0.4 ml / 30 sec

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Nasopalatine Nerve Block

• Failure
• May be only unilateral
• May have overlap with Greater Palatine
• Complications
• Ischemia, tissue necrosis
• Others rare