Mandibular injection techniques
- 2. Introduction Inferior alveolar nerve block Buccal nerve block Mental nerve block Incisive nerve block Reference
- 3. Mandibular nerve is a branch of trigeminal nerve it divides mainly into two branches after coming out from cranium through foramen ovale. Mandibular blocks: Inferior alveolar nerve block Buccal nerve block Incisive nerve block Mental nerve block Gow- gates mandibular nerve block Vazirani-Akinosi nerve block
- 4. Most frequently used(direct technique) Most important injection technique in dentistry Other common name: mandibular block Nerves anesthetized 1. Inferior alveolar 2. Incisive 3. Mental 4. Lingual
- 6. Indications:Procedures on multiple mandibular teeth in one quadrant When Buccal soft tissue anaesthesia is necessary Contraindications Advantage Disadvantage Area of insertion Target area Landmarks(Coronoid notch,pterygomandibular raphe,occlusal plane of mandibular posterior teeth) complications: hematoma, trismus, facial paralysis) Depth of penetration:20-25 mm
- 7. Needle position in halstead approach 1. First position: inferior alveolar nerve is Anaesthetized from the opposite side 2. Second position: lingual nerve is anaesthetized from the opposite side 3. Third position: long buccal nerve is Anaesthetized separate In indirect technique(Fischer 1-2-3) 1. First position: long buccal nerve is Anaesthetized from the opposite side 2. Second position: lingual nerve is Anaesthetized from the same side 3. Third position: inferior alveolar nerve is Anaesthetized from the opposite side
- 8. Nerves anesthetized Areas anesthetized:soft tissues and periosteum buccal to the mandibular molar Indication Contraindication Advantage Disadvantage: Potential for pain if the needle contacts the periosteum during injection
- 9. Area of insertion : mucous membrane distal and buccal To the most distal tooth Target:Long buccal nerve as it passes through anterior border of ramus Landmarks: Mandibular molar and muccobuccal fold Depth of penetration :1-2 mm
- 10. Nerves Anaesthetized Areas Anaesthetized:Buccal mucous membrane anterior to the mental foramen to the midline skin of chin ,lowerlip Indication:Soft tissue biopsies,suturing of soft tissues Contraindication advantages Disadvantage :Hematoma
- 11. Area of insertion: muccobuccal fold at Or just anterior to the mental foramen Target area:Mental nerve as it exists the mental foramen Landmarks: mandibular Premolars and muccobuccal fold Depth of penetration:5-6mm
- 12. Nerves anesthetized: Incisive,mental Areas anesthetized:Buccal mucous membrane anterior To the mental foramen, usually from the second Premolar to The midline Lower lip and skin of the chin Pulpal nerve fibres to the Premolars,canine and incisors Indication: dental procedures requiring pulpal anesthesia on mandibular teeth anterior to the mental foramen Contraindication Advantage:Provides pulpal and hard tissue anesthesia without lingual anesthesia Disadvantage Complications
- 13. Area of insertion: Muccobuccal fold at or just anterior to the mental foramen Target area:Mental Foramen through which the mental nerve exists and inside of which the incisive nerve is located Landmarks:mandibular Premolars and muccobuccal fold Depth of penetration:5-6mm
- 14. Handbook of local anesthesia ,Stanley.f.malamed Textbook of oral and maxillofacial surgery sm balaj