Cadaveric Study for Intraoral Needle Access to the Infratemporal Fossa: Application to Posterior Superior Alveolar Nerve Block Technique.

Publication Title

Cureus

Authors

Joe Iwanaga
Emily Simonds
Rod J Oskouian, Swedish Neuroscience Institute, Swedish Medical Center, Seattle, Washington, USAFollow
R Shane Tubbs

Document Type

Article

Publication Date

10-9-2017

Keywords

anatomy; endodontics; mandible; maxilla; nerve block; superior alveolar nerve; wisdom tooth

Abstract

The posterior superior alveolar (PSA) nerve block is, from an anatomical perspective, challenging because the mandibular ramus and the zygomatic process of the maxilla can interfere with the course of the needle. Dentists empirically know that shifting the patient's mandible to the ipsilateral side can improve visibility and accessibility for such blocks. This cadaveric study aimed to establish anatomical evidence for the ipsilateral mandible shifting used in the PSA. The distance between the lateral most bulging point of the alveolar part of the maxilla and ipsilateral anterior border of the ramus of the mandible ranged from 1.4 to 6.9 mm with a mean of 4.3 ± 1.6 mm. This result supports the empirical technique of shifting the mandible ipsilaterally for PSA nerve block.

Area of Special Interest

Neurosciences (Brain & Spine)

Specialty/Research Institute

Surgery

Specialty/Research Institute

Neurosciences