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Omar Masabni [1] and Maha Ahmad [2]

Academic Editor: Ruijin Huang

1, Department of Periodontology and Dental Hygiene, University of Detroit Mercy School of Dentistry, Detroit, MI, USA, udmercy.edu

2, Department of Biomedical and Diagnostic Sciences, University of Detroit Mercy School of Dentistry, Detroit, MI, USA, udmercy.edu

Received Aug 25, 2017; Accepted Dec 3, 2017

This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

1. Introduction

Nerve blocks, used to anesthetize the maxillary incisors, canine, and premolars, target the infraorbital nerve (ION) [1], a branch of the maxillary division (V2) of the trigeminal nerve. The ION enters the orbit through the inferior orbital fissure and then transverses the infraorbital canal located under the floor of the orbit [2]. While the ION is in the canal, it provides sensory innervations to the maxillary anterior teeth (anterior superior alveolar nerve), premolars (middle superior alveolar nerve), and associated gingiva. The ION exits the orbit through the infraorbital foramen (IOF) where it becomes a terminal branch, dividing into three branches that provide sensory innervations to the upper lip (superior labial nerve), lateral side of the nose (lateral nasal nerve), and lower eyelid (inferior palpebral nerve).

The greater palatine nerve (GPN) is a branch of the pterygopalatine ganglion that descends downward into greater palatine canal (GPC) and emerges into the oral cavity at the level hard palate through the greater palatine foramen.

The IOF is located in close proximity to vital anatomical structures; therefore proper identification of its location during regional block anesthesia is highly recommended [3, 4]. However, this can be challenging due to its anatomical variation. Several previous studies attempted to determine the location of the IOF by the use of different reference points during ION block anesthesia. One of the constant reference points used is the maxillary second premolar [2, 5–8], as it lies in the same sagittal plane as the IOF.

A previous research paper used GPC to give a maxillary nerve block in the superior aspect of the pterygopalatine fossa [2], while another research study inserted the needle at a lower level inside pterygopalatine fossa [9].

The aim of this study was to locate...

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