[Alveolar anesthesia]

Tuberosity anesthesia is a loco-regional anesthesia aiming at anesthetizing with a single injection the superoposterior alveolar nerves, by approaching the maxillary tuberosity through a direct anteroexternal pathway. This anesthesia involves an area located behind the pyramidal process of the maxillary bone which includes the molars, gingival buccal mucosa, sinus bone and mucosa. Well-tolerated by the patient, since it is practically a painless procedure, tuberosity anesthesia is the preferred method to perform surgery in the posterior maxillary area. Its administration may be extended without condition to treatment of the upper molars: custy + crown + bridge preparations on vital teeth, pulpectomies, thanks to the rapid onset and efficacy of the anesthesia obtained. The only contraindication involves patients with vascular or hematologic disorders, ruling out procedures where a blood vessel might be injured with a needle. In that case, intraligamentary or transcortical instillation is indicated since para-apical anesthesia is not a valid alternative due to the proximity of the external alveolar artery.