Maxillary nerve block is used for which of the following procedures?

• A. Limited to anterior implants
• B. Extensive oral surgical, periodontal, or restorative procedures
• C. Mandibular molar extractions
• D. Soft tissue grafts in the mandible

Answer: (B)

The concept being tested is the extent of anesthesia provided by a maxillary nerve block. Blocking the maxillary division of the trigeminal nerve before it branches gives anesthesia to a large area of the upper jaw—the teeth from the canine to the third molar on the treated side, plus the associated buccal and palatal soft tissues supplied by the maxillary nerve. This broad coverage makes it ideal for extensive maxillary procedures that involve multiple teeth or large regions, such as complex surgical, periodontal, or restorative work. It wouldn’t be used for mandibular procedures, because the mandible is innervated by the inferior alveolar nerve (a branch of V3), and a maxillary nerve block would not provide reliable anesthesia there. Limiting its use to anterior implants is unnecessarily narrow given the wide reach of this block, and soft tissue grafts in the mandible require mandibular anesthesia.