Maxillary molar block technique for children
This is a valuable technique, especially where infiltration is not possible because of localized infection, and produces profound analgesia of the maxillary primary/permanent molars. It results in a block of the posterior and often middle superior dental nerves as they enter the posterior maxilla in the infratemporal fossa. However, unlike the direct posterior superior nerve block technique, it does not carry the risk of damaging the vascular pterygoid plexus with subsequent haematoma formation.
Figure 1 : The maxillary zygomatic buttress is palpated with the index finger.
Figure 2 : A bolus of 1.5–2 ml local analgesic solution is deposited distal to the buttress.
Figure 3: Once deposited, the analgesic solution is massaged around the distal aspect of the maxilla with the index finger. The patient should be asked to occlude at this stage. This prevents the coronoid process of the mandible blocking distal movement of the finger.
Figure 4 : The maxillary molar block. The bolus of local analgesic solution is deposited below the mucosa distal to the zygomatic buttress (A). The analgesic solution is then massaged around the distal aspect of the maxilla into the infratemporal fossa (B) and blocking the posterior superior dental nerves (PSDN).