Maxillary Infiltration Injections
What it numbs:
Maxillary Infiltrations are used to achieve pulpal anesthesia of one or two teeth. The areas anesthetized is the pulp, buccal soft tissue and bone of the tooth being anesthetized. Infiltration injections are anesthetizing the long terminal branches of the nerves.
The maxillary infiltration injection anesthetizes the pulp soft tissue and bone in the areas of the injection site.
A 25 or 27 short gauge are recommended.
Patient position is supine.
Operator position is going to depend on the areas being anesthetized.
The landmarks are the mucobuccal fold parallel to the root and apex of the tooth close to the bone.
The target area and injection site is located at the height of the mucobuccal fold parallel to the long axis of the tooth to be anesthetized.
The bevel of the needle should be toward the bone and inserted at a depth that is at or above the apex of the tooth.
There is no pressure anesthetic or osseous contact needed with infiltration injections. aspiration potential is less than one percent.
Aspirate, if after two negative aspirations slowly inject 1/3 of the carpule over 20 seconds.
If isolated areas of the lingual tissue require anesthetic, local infiltration can be accomplished by inserting the short needle though the interdental papilla on both the mesial and distal of the tooth being treated. This will provide adequate anesthetic for scaling, root planning and curettage with out the patient having to experience more profound anesthesia.
Document in patient record, what injection you gave, who gave it, what kind of anesthetic, how much anesthetic, negative aspiration, no complications, ect.
For more information and references:
Malamed SF. In: Handbook of local anesthesia. 4th ed. Noida, India: Harcourt Brace; 1997.