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Local Anesthesia Cheat Sheet (DRAFT) by

local anesthesia techniques

This is a draft cheat sheet. It is a work in progress and is not finished yet.

3 major types of local anesthesia

local infilt­ration
field block
nerve block

Nerve Blocks

block type
landmarks
area anesth­etized
posterior superior alveolar nerve block
mucogi­ngival sulcus, maxillary tubero­sity, zygomatic process of maxilla
maxillary molar tooth pulps, MB root of first molar (in 72%), buccal period­ontium and bone
middle superior alveolar nerve block
depth of mucogi­ngival sulcus above maxillary second premolar
premolars, MB root of first molar (28%), buccal period­ontium and bone
anterior superior alveolar nerve/­inf­rao­rbital nerve block
locate foramen by palpation
maxillary central through canine, premolars, MB root of first molar (28%), buccal period­ontium and bone, lower eyelid, side of nose, upper lip

Lingual nerve blocks

nerve block
landmarks
area anesth­etized
inferior alveolar nerve block (Halstead)
Gow-Gates mandibular block
extraoral: lower border of tragus (inter­tragic notch), corner of mouth; intraoral: height of injection establ­ished by placement of needle tip just below the mesiop­alatal cusp of maxillary second molar
nerves: inferior alveolar, lingual, mylohyoid, auricu­lot­emp­oral, buccal (in 75%)
Vazira­ni-­Akinosi block
mucogi­ngival junction of maxillary third or second molar, maxillary tubero­sity, coronoid notch on mandibular ramus
nerves: inferior alveolar, lingual, mylohyoid
infilt­ration in lingual sulcus

Advantages and Disadv­antages

nerve block
advantages
disadv­antages
PSA
MSA
ASA/in­fra­orbital
greater palatine
nasopa­latine
buccal
inferior alveolar
mental
incisive
inferior alveolar (Halstead)
gow-gates
vazira­ni-­akinosi
 

Local infilt­ration

suprap­eri­osteal

Palatal anesthesia

nerve block
landmarks
area anesth­etized
greater palatine nerve block
greater palatine foramen, junction of maxillary alveolar process and palatine bone adjacent to maxillary first molar
posterior portion of hard palate, overlying soft tissues, NO anesthesia of teeth
nasopa­latine nerve block
central incisors, incisive papilla
anterior portion of hard palate, both hard and soft tissues, NO anesthesia of teeth

Mandibone anesthesia

nerve block
landmarks
area anesth­etized
buccal nerve block
mandibular molars, mandibular buccal vestib­ule­/mu­cog­ingival sulcus
gingival buccal to molars, retromolar pad mucosa, buccal mucosa in molar area, NO hard tissues anesth­etized
inferior alveolar nerve block
coronoid notch, pteryg­oma­ndi­bular raphe (vertical portion), occlusal plane of mandibular posterior teeth
nerves: inferior alveolar, incisive, mental, lingual (usually); blocks entire quadrant (half of mandible from molars to central)
mental nerve block
mandibular premolars, mandibular buccal vestibule
mucosa anterior to foramen, skin of lower lip, chin, anterior mandibular teeth (incisive branch of IAN)
incisive nerve block
?
mucosa on buccal, lower lip, skin of chin, premolars, canines, incisors

Indica­tions for use

nerve block
indica­tions
PSA
MSA
ASA/in­fra­orbital
greater palatine
nasopa­latine
buccal
inferior alveolar
mental
incisive
inferior alveolar (halstead)
gow-gates
vazira­ni-­akinosi