mandibular injections Flashcards
buccal nn location btwn what mm?
Buccal Nerve
Between Lateral Pterygoid Heads
buccal nn functions
Sensory to Cheek Area
Sensory to Molar Buccal Gingiva
buccal nn injection site
anterior aspect of the ramus/lateral
buccal nn block needle
Injection – 25 Gauge Long Needle
what to do with tissue in buccal nn block
stretch tissue
what should you contact with needle in buccal nn block
periosteum
Buccal Nerve Block
Tissues Anesthetized
*Gingiva buccal to molars
*Retromolar pad mucosa
*Buccal mucosa in molar area
*NO hard tissues anesthetized
Buccal Nerve Block
Indications
*When buccal soft tissue
anesthesia is required
Buccal Nerve Block
Advantages
*High success rate
*Easy injection to administer
*Atraumatic
Mandibular Nerve
Posterior Division branches
Primarily sensory
*Auriculotemporal nerve
*Lingual nerve
*Inferior alveolar nerve
*Mylohyoid nerve
Auriculotemporal Nerve
Areas Innervated
*Skin over areas supplied by VII
*Skin over helix and tragus of ear
*Skin of external auditory meatus
*Posterior part of TMJ
*Skin over temporal area
Auriculotemporal Nerve location
second branch of posterior division of man nn
lingual nn
Lingual NerveInnervates:
Innervates Anterior 2/3 of Tongue
nnervates Lingual Mucosa
Lingual Nerve Blocked With:
*Inferior Alveolar Block
*Mandibular Block
*Gow-Gates Mandibular Block
*Vazirani-Akinosi Block
*Infiltration in lingual sulcus
what block is this?
lingual infiltration
Largest Branch of Posterior Division
IA
foramen and ligament associated with IA
what landmark is used for typical IA blocks
coronoid notch, want needle injected at this level from across the arch at contralateral PM region
when doing an IA block what mm is penetrated
buccinator
Inferior Alveolar Nerve Block
Penetration Lateral to:
Lateral to Pterygomandibular Raphe
Inferior Alveolar Nerve Block
Site Between what landmarks?
Raphe and Notch
steps to IA block
- dry site
- topical anesthetic, wait 1-2min
- Finger on Notch Retracts Cheek and
Determines Height of Injection - Note Site of Needle Insertion
- Barrel of Syringe in Corner of Mouth
- Insert~25mm to Contact Bone
- Aspirate, Inject 1.5 ml over 60 Sec.
- Withdraw Halfway, Deposit 0.1 ml at
Lingual Nerve
Inferior Alveolar Nerve Block
Nerves Anesthetized
*Inferior alveolar
*Incisive
*Mental
*Lingual (usually)
Inferior Alveolar Nerve Block
Indications
*Wide area requires anesthesia
*Buccal tissue anesthesia is needed
*Lingual soft tissue anesthesia is
needed
Inferior Alveolar Nerve Block
Contraindications
*Infection in area
*Acute inflammation in area
*Patient a potential lip-biter
Inferior Alveolar Nerve Block
Advantages
*Provides wide area of anesthesia
*Minimizes anesthetic dose
Inferior Alveolar Nerve Block
Disadvantages
*Wide area anesthetized
*Unsuccessful in 15 to 20%
*Inconsistent oral landmarks
*10-15% positive aspiration