The ability to achieve profound local anesthesia for patients in general, and endodontic patients in particular, can be impacted by
many factors. These include the inflammatory process, anatomical structures and neural variations. In order to efficiently and effectively manage endodontic emergencies in a relatively painless manner, the clinician must understand all of these considerations.
Local anesthetic techniques for the maxillary and mandibular arches that included both inferior mandibular nerve blocks and maxillary infiltrations are usually sucessful, however, at times supplemental or alternative approaches to achieve profound anesthesia are necessary for total patient comfort and clinician achievement.