Presentation on theme: "LOCAL ANESTHESIA FOR THE DENTAL HYGIENIST:"— Presentation transcript:
1LOCAL ANESTHESIA FOR THE DENTAL HYGIENIST: Anatomy Review
2Main Structures Involved: Facial Bones of the Skull: -Maxilla, Mandible, and Palatine bones Cranial Nerve V—Trigeminal nerve: V2-Maxillary branch of the Trigeminal nerve V3-Mandibular branch of the Trigeminal nerve
3Cranial Nerves Emerge from the inferior surface of the brain All pass through the foramina (window like opening) of the skull to innervate structures in the head, neck, and facial region
6Trigeminal Nerve Largest cranial nerve/Most Important Short trunk from brain with 2 rootsAfferent /Sensory Root [larger]Has trigeminal ganglionOpthalmic V1Maxillary V2Mandibular V3Motor /Efferent root [smaller]Muscles of masticationParasympathetic to salivary glands
7Cranial Nerve V (Trigeminal) 3 Divisions/branchesV1 entirely afferentV2 entirely afferentV3 mixed, both afferent and efferent
9V-1 Ophthalmic Division Enters the eye through the Superior orbital fissureSensation to conjuctiva, cornea, eyeball, orbit, forehead, ethmoid sinus, frontal sinus, dura mater of brain
10V-2 Maxillary Division Afferent (Sensory) nerve for: Enters the skull through the Foramen RotundumAfferent (Sensory) nerve for:Maxilla and overlying skin and dental plexusMaxillary sinusesNasal cavityPalateNasopharynxPart of dura mater
11V2 Branches: Infraorbital Nerve Sensation for upper lip, medial cheek, lower eyelid and side of the nosePasses through infraorbital sulcus (groove in floor of orbit) becomes:Infraorbital canal which terminates at:Infraorbital foramen
12V2 Branches: Anterior Superior Alveolar (ASA) Sensation for Maxillary centrals, laterals, canines, and associated tissuesOriginates in pulp tissues of teeth at apical foramenJoins the infraorbital nerve along anterior wall of maxillary sinusMay cross over midline.
13V2 Branches: Middle Superior Alveolar (MSA) Sensation for Maxillary premolars and mesiobuccal root of the 1st molar, and buccal gingiva.Originates in pulp tissues of teeth at apical foramenJoins the infraorbital nerve along lateral wall of maxillary sinusNot present on all patients.Communicates with ASA and PSA nerves.
14V2 Branches: Posterior Superior Alveolar (PSA) Sensation for Maxillary 1st (except MB root), 2nd, 3rd molars, buccal gingiva, and maxillary sinus.Originates in pulp tissues of teeth at apical foramenJoins the infraorbital nerve along lateral wall of maxillary sinusCommunicates with ASA and MSA nerves.
15V2 Branches: Greater Palatine Nerve Posterior hard palate and posterior lingual gingivaEnters Greater palatine foramen near 2-3rd molar
16V2 Branches: Lesser Palatine Nerve Soft Palate and palatine tonsillar tissuesEnters lesser palatine foramen near pterygoid process
17V2 Branches: Nasopalatine Nerve Mucosa of anterior hard palate and lingual gingiva of maxillary teethEnters incisive foramen beneath incisive papillaTravels along nasal septumCommunicates with GP nerve lingual to the maxillary canines
18V-3 Mandibular Division Enters the skull through the Foramen Ovale in Sphenoid boneLargest of three divisionsSensory root to:CheekExternal ear and scalpTongueSubmand/Sublingual salivary glandsFloor of the mouthMandibular dental plexusMotor root to:Muscles of MasticationPalatal muscles
19V3 Branches: Buccal Nerve Skin of cheekBuccal mucosaBuccal gingiva of mandibular posterior teethLocated on surface of buccinator muscle
20V3 Branches: Lingual Nerve Lateral surface of the tongueSlightly medial to Inferior alveolar nerveSensory for body of the tongue, floor of the mouth, and lingual gingiva of mandibular teeth
21V3 Branches: Mental Nerve Sensory for chin, lower lip, and labial mucosa of mandibular pre-molars, and anterior teethMerges with the incisive nerve to form the IA nerveEnters the mental foramen on the anterior surface of the mandible near 1st and 2nd premolar apices
22V3 Branches: Incisive Nerve Sensory for mandibular premolars and anterior teeth pulp tissueMerges with the mental nerve to form the IA nerveMay crossover midlineEnters the mental foramen on the anterior surface of the mandible near 1st and 2nd premolar apices
23V3 Branches: Inferior Alveolar Nerve Sensory for mandibular teethFormed from merger of the mental and incisive nervesExits the mandibular foramen on the lingual surface of the ramus
24V3 Branches: Mylohyoid Nerve Efferent (motor) for mylohyoid muscle and anterior belly of digastric muscleMay serve as a afferent nerve for mandibular 1st molar if IA nerve block failure