Local infiltration of the palate provides anesthesia of the terminal branches of the nasopalatine and greater palatine nerves. The soft tissues in the immediate area of the injection site are anesthetized.
The indications for local infiltration are for achieving hemostasis during surgical procedures and when pain control of localized areas is necessary such as application of rubber dam or subgingival placement of matrix bands on no more than two teeth. It may supplement inadequate areas of anesthesia from nasopalatine and greater palatine alveolar blocks. It is contraindicated when there is infection or inflammation in the injection area. It can be a traumatic injection for the patient.
A multiple penetration technique may be used. Following the steps as described previously, after buccal or labial anesthesia is achieved, interpapillary injection is performed to attain palatal tissue anesthesia observed by blanching of the mucosa (Figure 15). It is to be noted that palatal infiltration is the most painful injection technique due to close approximation of palatal mucosa to the periosteum of the bone.
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