Which injection provides pulpal anesthesia of ipsilateral maxillary teeth, buccal periodontium and bone overlying these teeth, the soft tissues and bone of the hard palate and part of the soft palate to the midline, and the skin of the lower eyelid, side of the nose, cheek, and upper lip?

• A. Nasopalatine nerve block
• B. Infraorbital nerve block
• C. Maxillary nerve block
• D. Greater palatine nerve block

Answer: (C)

Blocking the maxillary nerve trunk anesthetizes the entire ipsilateral maxillary region because this nerve carries all the sensory fibers that supply the teeth, the surrounding hard and soft tissues, and the overlying skin on that side. The teeth receive pulpal sensation through its alveolar branches (anterior, middle, and posterior superior alveolar nerves), while the buccal periodontium and the bone overlying those teeth share these branches. The palate and hard-palate mucosa (and parts of the soft palate) are served by the palatal nerves that originate from the maxillary division, including the greater palatine and nasopalatine nerves (with lesser palatine nerves contributing to the soft palate). Finally, the skin of the lower eyelid, side of the nose, cheek, and upper lip is supplied by branches that come off the maxillary nerve as it gives rise to the infraorbital distribution. By blocking the maxillary nerve trunk, you interrupt all these pathways before they branch, producing pulpal anesthesia of the maxillary teeth, buccal tissues, palatal tissues to the midline, and the facial skin in that region. The other blocks alone cover more limited territories (for example, only palate, or only teeth with facial soft tissue, but not the full palatal plus facial skin distribution), so they do not match the complete pattern described.