IAN (Lingual)

Question 1

What is the bony landmark for the IAN?

Answer 1

Superior to the lingual on the medial border of the ramus of the mandible

Question 2

What is the soft tissue landmark of the IAN?

Answer 2

Anterior border of the pterygomandibular space

Question 3

What is the orientation of the IAN syrigne?

Answer 3

Vertical - heigh of injection is 1 cm above lower occlusal plane
Horizontal - syringe barrel is over the premolars on the contralateral side

Question 4

What is the needle depth for the IAN?

Answer 4

25mm until hit bone - long withdraw slightly then aspirate

Long Needle 40mm

Question 5

How much LA do you deposit for the IAN?

Answer 5

1.5-1.8ml over 60 sec

Question 6

What is the target nerve of the IAN?

Answer 6

Inferior Alveolar Nerve and Lingual Nerve

Question 7

Which structures are anaesthetised in an IAN?

Answer 7

IAN - All mandibular teeth pulp. Buccal gingiva and periosteum, CT & mucous membrane anterior to first molar
Lingual Nerve - Lingual Gingiva, Floor of Mouth and anterior 2/3 of the tongue

Question 8

What are the precautions/considerations of the IAN?

Answer 8

Size of buccal fat pad, size of ramus, morphology o lingual, dental arch shape and alignment of teeth, if patient says tongue not numb, slightly withdraw from target area, aspirate and deposit 0.5ml to target lingual nerve, partial anaesthesia at midline due to nerve plexus and overlapping supply

Question 9

How many planes do you aspirate in for an IAN?

Answer 9

Two