AMSA Injection
Common names for injection - answer- Palatal approach AMSA nerve block
Nerves anesthetized - answer- ASA nerve
- MSA nerve (when present)
- Subneural dental nerve plexus of the ASA and MSA nerves
Areas anesthetized - answer- ASA, MSA (when present) nerves and subneural nerve
plexus
- Pupal anesthesia of maxillary incisors - premolars and buccal attached gingiva
- Attached palatal tissues from midline to free gingival margin on associated teeth
Landmarks - answerThe intersecting point midway along a line from the mid-palatine
suture to the free gingival margin intersecting the contact point between the first and
second premolars
Bevel orientation - answerToward palatal tissues
Penetration / insertion site - answerIn the hard palate about halfway along an imaginary
line connecting the mid-palatal suture to the free gingival margin. The location of the line
is at the contact point between the first and second premolars
Penetration depth - answer~ until bone is gently contacted (~ 4-6 mm)
Target area (terminal deposition site) - answerTissue of the hard palate. The solution
penetrates through small pores in the palate to the anterior and middle part of the dental
plexus
Amount of anesthetic deposited - answer1.4 - 1.8 mL (0.5 mL/min = ~ 1/4 cartridge per
min)
Length of time to deposit - answer5 mL/min
Positive aspiration rate - answerNegligible <1%
Indications and advantages? - answer- Used for anesthesia covering a large area that is
normally innervated by the ASA, MSA, and NP blocks
- Anesthesia needed on multiple maxillary teeth
- When a facial approach supraperiosteal injection has been ineffective due to dense
cortical bone
- Minimizes volume of anesthetic
- Minimizes number of injections needed
Common names for injection - answer- Palatal approach AMSA nerve block
Nerves anesthetized - answer- ASA nerve
- MSA nerve (when present)
- Subneural dental nerve plexus of the ASA and MSA nerves
Areas anesthetized - answer- ASA, MSA (when present) nerves and subneural nerve
plexus
- Pupal anesthesia of maxillary incisors - premolars and buccal attached gingiva
- Attached palatal tissues from midline to free gingival margin on associated teeth
Landmarks - answerThe intersecting point midway along a line from the mid-palatine
suture to the free gingival margin intersecting the contact point between the first and
second premolars
Bevel orientation - answerToward palatal tissues
Penetration / insertion site - answerIn the hard palate about halfway along an imaginary
line connecting the mid-palatal suture to the free gingival margin. The location of the line
is at the contact point between the first and second premolars
Penetration depth - answer~ until bone is gently contacted (~ 4-6 mm)
Target area (terminal deposition site) - answerTissue of the hard palate. The solution
penetrates through small pores in the palate to the anterior and middle part of the dental
plexus
Amount of anesthetic deposited - answer1.4 - 1.8 mL (0.5 mL/min = ~ 1/4 cartridge per
min)
Length of time to deposit - answer5 mL/min
Positive aspiration rate - answerNegligible <1%
Indications and advantages? - answer- Used for anesthesia covering a large area that is
normally innervated by the ASA, MSA, and NP blocks
- Anesthesia needed on multiple maxillary teeth
- When a facial approach supraperiosteal injection has been ineffective due to dense
cortical bone
- Minimizes volume of anesthetic
- Minimizes number of injections needed
