Intraoral anesthesia of the maxillary nerve with a curved needle

Abstract

Introduction Anesthesia of the maxillary nerve using an extraoral approach requires the preparation of the operative field, the use of long non-standard needles, and the procedure is very painful. Therefore an intraoral approach could have great advantages. Aim The aim of this paper was to present the intraoral approach to maxillary nerve anesthesia using a curved needle, having in mind that such a procedure is less traumatic to the patient and easy to perform. Method In order to achieve maxillary nerve anesthesia, the intraoral route with a curved needle was used. A standard disposable 10 ccm syringe was used with an intramuscular needle 22G 40 mm long, which was curved with the protective cap at the 90 degrees angle, starting from the midpoint of the needle. After broadening the chick with a blunt hook, the needle was placed behind and above the maxillary tuber. The curved part of the needle was in the coronl plane and perpendicular to the axis passing through the nasion in the ventral-dorsal direction. After passing through the pterygomaxillary fissure and the preventive aspiration, 4 ml of the Lidocaini hydrochloridi with adrenalini 1:200000 was injected. Results In indicated cases the procedure was conducted in 65 patients. The desired analgesia was achieved in the region of n. maxillaris, but additional infiltrative anesthesia was necessary in the incisor region. Conclusion Anesthesia of the maxillary nerve performed as described in this case report is a reliable and simple procedure that does not require additional equipment. Unlike the extraoral approach, it is easier to perform, more precise and comfortable for the patient.