VN July 2023

Vetnuus | July 2023 40 The maxilla is innervated by the maxillary nerve, a sensory branch of the trigeminal nerve (Cranial nerve V). The nerve courses through the infraorbital canal and gives off several branches: the caudal superior alveolar nerve branching off before the infraorbital nerve enters the infraorbital canal, the middle superior alveolar nerve branching off as the infraorbital nerve enters the canal, and the rostral superior alveolar nerve branch off just before the infraorbital nerve exits the canal. The caudal superior alveolar nerve supply sensory branches to the maxillary 4 th pre-molar tooth and molar teeth, the middle superior alveolar nerve supply sensory branches to the maxillary pre-molar teeth, and the rostral superior alveolar nerve supply sensory branches to the canine and incisor teeth. 1 MAXILLARY NERVE BLOCK The maxillary bone, soft and hard palate, teeth from the 2 nd molar (1 st molar in cats) rostrally and all soft tissue on the side infiltrated will be affected with a maxillary nerve block. 1,2 This also includes the skin of the nose, cheek and upper lip on the same side. Intra-oral approach. The needle can be bent slightly tomake access to the area easier. In dogs, the needle is inserted centro-caudally of the 2 nd molar tooth, perpendicular to the horizontal level of the palatine bone, and advanced to the level just dorsal of the root tips of the 2 nd molar tooth (Fig. 1). The local anaesthetic can then be slowly infiltrated in this area. In cats, the maxillary nerve block is performed just medial to the caudal root of the 4 th pre-molar tooth, where the base of the ‘V” notch can be palpated at the junction of the hard and soft palate. 2 Regional nerve blocks in veterinary dentistry II: Specific nerve blocks of the canine and feline maxilla. Dr. Mareli van de Wetering (VetdentSA) and Prof. Gerhard Steenkamp (UP) Fig. 1. A needle is bent about 45 degrees, and the patient is approached intraorally. The needle is inserted dorsally just caudal to the last molar tooth (A). A lateral view of the skull with the correctly placed needle (B) shows the needle close to the entrance of the maxillary artery into the infraorbital cana Fig. 2. A needle is inserted in the direction of the infraorbital foramen. This opening is located dorsally to the caudal root of the 3rd pre-molar tooth