Two intraoral approaches to the maxillary nerve
are described. The first, the "high tuberosity
approach"''( involves insertion of the needle in the
region of the mucobuccal fold at the maxillary 2nd
molar and advancing the needle in a posterior,
superior, and medical direction, into the region of
the pterygopalatine fossa. While technically a simple
approach to the maxillary nerve block, the high tuberosity
approach presents with several negatives,
primary amongst which is a greater incidence of periand
post-operative complications, such as hematoma.
It also requires a heavier than 25 gauge, long
needle (32mm.) to prevent deflection. Such needles
are not a common part of the local anesthetic armamentarium
in dental practice.