Posterior Superior Alveolar Nerve Block, a Dilemma for Dental Practitioners - A Case Report

Posterior superior alveolar (PSA) injection technique delivers the local anesthetic agent on to the posterior surface of maxilla targeting posterior superior alveolar branch of maxillary nerve. This nerve block anaesthetizes maxillary molars of the respective side, bone and soft tissues covering these teeth. This technique when administered correctly will provides complete anaesthesia in the desired regions and also reduce the number of injections administered, but the presence of pterygoid venous plexus and posterior superior alveolar branch of maxillary artery in the area of administration poses the risk of complications during administration. This article describes case of an unusual hematoma that occurred following administration of posterior superior alveolar nerve. Also review about the existing literature about possible complications during PSA nerve block and techniques to avoid them have been discussed.