Ace the Maxillary Anesthesia Challenge 2026 – Master Your Anatomy Game!

The high tuberosity approach is aimed at reaching the posterior superior alveolar nerve as it enters the maxilla near the pterygopalatine fossa, so the needle must be advanced to a deeper level to position the tip close to that nerve trunk. About 30 mm of insertion depth places the needle tip in the vicinity of the PSA nerve, enabling effective diffusion of anesthetic along the nerve to cover the molar region.

Using a standard cartridge volume of 1.8 mL provides enough local anesthetic to bathe the nerve fibers without excessive spread. If the needle is not driven in enough depth, the anesthetic may not reach the PSA nerve and anesthesia will be inadequate. A smaller volume like 0.5 mL is typically insufficient for reliable PSA anesthesia. Conversely, a larger volume such as 2.0 mL is unnecessary given the standard cartridge amount and can increase the risk of diffusion to unwanted areas.