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LOCAL ANESTHESIA FOR THE DENTAL HYGIENIST:

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Presentation on theme: "LOCAL ANESTHESIA FOR THE DENTAL HYGIENIST:"— Presentation transcript:

1 LOCAL ANESTHESIA FOR THE DENTAL HYGIENIST:
Anatomy Review

2 Main 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

3 Cranial 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

4 Cranial Nerves (12 pairs)
I- Olfactory II- Optic III- Oculomotor IV- Trochlear V- Trigeminal VI- Abducent VII- Facial VIII-Vestibulocochlear IX- Glossopharyngeal X- Vagus XI- Accessory XII- Hypoglossal

5 Trigeminal Nerve - V

6 Trigeminal Nerve Largest cranial nerve/Most Important
Short trunk from brain with 2 roots Afferent /Sensory Root [larger] Has trigeminal ganglion Opthalmic V1 Maxillary V2 Mandibular V3 Motor /Efferent root [smaller] Muscles of mastication Parasympathetic to salivary glands

7 Cranial Nerve V (Trigeminal)
3 Divisions/branches V1 entirely afferent V2 entirely afferent V3 mixed, both afferent and efferent

8 Foramen of the Trigeminal Nerve

9 V-1 Ophthalmic Division
Enters the eye through the Superior orbital fissure Sensation to conjuctiva, cornea, eyeball, orbit, forehead, ethmoid sinus, frontal sinus, dura mater of brain

10 V-2 Maxillary Division Afferent (Sensory) nerve for:
Enters the skull through the Foramen Rotundum Afferent (Sensory) nerve for: Maxilla and overlying skin and dental plexus Maxillary sinuses Nasal cavity Palate Nasopharynx Part of dura mater

11 V2 Branches: Infraorbital Nerve
Sensation for upper lip, medial cheek, lower eyelid and side of the nose Passes through infraorbital sulcus (groove in floor of orbit) becomes: Infraorbital canal which terminates at: Infraorbital foramen

12 V2 Branches: Anterior Superior Alveolar (ASA)
Sensation for Maxillary centrals, laterals, canines, and associated tissues Originates in pulp tissues of teeth at apical foramen Joins the infraorbital nerve along anterior wall of maxillary sinus May cross over midline.

13 V2 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 foramen Joins the infraorbital nerve along lateral wall of maxillary sinus Not present on all patients. Communicates with ASA and PSA nerves.

14 V2 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 foramen Joins the infraorbital nerve along lateral wall of maxillary sinus Communicates with ASA and MSA nerves.

15 V2 Branches: Greater Palatine Nerve
Posterior hard palate and posterior lingual gingiva Enters Greater palatine foramen near 2-3rd molar

16 V2 Branches: Lesser Palatine Nerve
Soft Palate and palatine tonsillar tissues Enters lesser palatine foramen near pterygoid process

17 V2 Branches: Nasopalatine Nerve
Mucosa of anterior hard palate and lingual gingiva of maxillary teeth Enters incisive foramen beneath incisive papilla Travels along nasal septum Communicates with GP nerve lingual to the maxillary canines

18 V-3 Mandibular Division
Enters the skull through the Foramen Ovale in Sphenoid bone Largest of three divisions Sensory root to: Cheek External ear and scalp Tongue Submand/Sublingual salivary glands Floor of the mouth Mandibular dental plexus Motor root to: Muscles of Mastication Palatal muscles

19 V3 Branches: Buccal Nerve
Skin of cheek Buccal mucosa Buccal gingiva of mandibular posterior teeth Located on surface of buccinator muscle

20 V3 Branches: Lingual Nerve
Lateral surface of the tongue Slightly medial to Inferior alveolar nerve Sensory for body of the tongue, floor of the mouth, and lingual gingiva of mandibular teeth

21 V3 Branches: Mental Nerve
Sensory for chin, lower lip, and labial mucosa of mandibular pre-molars, and anterior teeth Merges with the incisive nerve to form the IA nerve Enters the mental foramen on the anterior surface of the mandible near 1st and 2nd premolar apices

22 V3 Branches: Incisive Nerve
Sensory for mandibular premolars and anterior teeth pulp tissue Merges with the mental nerve to form the IA nerve May crossover midline Enters the mental foramen on the anterior surface of the mandible near 1st and 2nd premolar apices

23 V3 Branches: Inferior Alveolar Nerve
Sensory for mandibular teeth Formed from merger of the mental and incisive nerves Exits the mandibular foramen on the lingual surface of the ramus

24 V3 Branches: Mylohyoid Nerve
Efferent (motor) for mylohyoid muscle and anterior belly of digastric muscle May serve as a afferent nerve for mandibular 1st molar if IA nerve block failure


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