A patient attends surgery for an extraction of the upper right lateral incisor which is palatally placed and periodontally involved. The dentist must anaesthetise which pair of the following nerves?

• A. Infraorbital and greater palatine nerves
• B. Anterior superior and nasopalatine nerves
• C. Inferior alveolar and lingual nerves
• D. Anterior superior and middle superior alveolar nerves

Answer: (B)

The key idea is knowing which nerves supply sensation to the maxillary anterior region and its palatal tissues. For the upper incisor area, the tooth itself and its buccal gingiva are supplied by the anterior superior alveolar nerve, a branch of the infraorbital nerve. To cover the palatal side—especially with a tooth that is palatally placed—you also need to block the nasopalatine nerve, which travels in the incisive canal and provides sensation to the palatal mucosa and gingiva of the anterior maxilla (and the anterior hard palate).

So, pairing the anterior superior alveolar nerve block with the nasopalatine nerve block ensures you numb both the tooth and the accompanying palatal tissues you’ll encounter during extraction. The other options don’t fit because they either target the wrong jaw region (inferior alveolar and lingual nerves for the mandible) or miss the necessary palatal coverage (the middle superior alveolar and greater palatine nerves don’t provide the required anterior palatal sensation).