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Inferior alveolar nerve anesthesia is a technique of dental anesthesia used to produce anesthesia of the mandibular teeth, gingival tissues of the mandible and the lower lip.
The proper use of local anesthesia techniques and pain management are indispensable for successful dental treatment. Although inferior dental anesthesia is a routine block injection administered regularly in dental practice, failure to achieve satisfactory levels of analgesia are noticed in few cases2.
What are the Mandibular Nerve Blocks
Mental – Incisive
We will be discussing about Inferior Alveolar Nerve Block
*Not a complete mandibular nerve block.
*Requires supplemental buccal nerve block
*May require infiltration of incisors or mesial root of first molar
NERVES THAT GET ANESTHETIZED
AREAS THAT GET ANESTHETIZED
Mandibular teeth to midline
Body of mandible, inferior ramus
Buccal mucosa anterior to mental foramen
Anterior 2/3 tongue & floor of mouth
Lingual soft tissue and periosteum
Multiple mandibular teeth
Buccal anterior soft tissue
Infection/inflammation at injection site
Patients at risk for self injury (eg. children)
10%-15% positive aspiration
Area of insertion:
medial ramus, mid-coronoid notch,
level with occlusal plane (1 cm above),
3/4 posterior from coronoid notch to
advance to bone (20-25 mm)
Anatomical Landmarks For Identification
Anterior border of the ramus of the mandible
External oblique ridge
Internal oblique ridge
Buccal sucking pad
Failure of Anesthesia
Injection too low
Injection too anterior
-Contralateral Incisive nerve innervation
1. Subjective symptoms – Tingling and numbness of lower lip and when the lingual nerve is affected, the tip of the tongue.
2. Objective symptoms – Instrumentation necessary to demonstrate absence of pain sensation.
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