Presentation is loading. Please wait.

Presentation is loading. Please wait.

Techniques of Mandibular Anesthesia. Mandibular Anesthesia Mandibular Anesthesia Lower success rate than Maxillary anesthesia - approx. 80-85 % Related.

Similar presentations


Presentation on theme: "Techniques of Mandibular Anesthesia. Mandibular Anesthesia Mandibular Anesthesia Lower success rate than Maxillary anesthesia - approx. 80-85 % Related."— Presentation transcript:

1 Techniques of Mandibular Anesthesia

2 Mandibular Anesthesia Mandibular Anesthesia Lower success rate than Maxillary anesthesia - approx % Related to bone density Less access to nerve trunks Less access to nerve trunks

3 Mandibular Nerve Blocks Inferior alveolar Mental - Incisive BuccalLingualGow-GatesAkinosi

4 Mandibular Anesthesia Most commonly performed technique Has highest failure rate (15-20%) Success depends on depositing solution within 1 mm of nerve trunk

5 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

6 Inferior Alveolar Nerve Block Nerves anesthetized Inferior Alveolar Inferior Alveolar Mental Mental Incisive Incisive Lingual Lingual

7 Inferior Alveolar Nerve Block Areas Anesthetized Mandibular teeth to midline Mandibular teeth to midline Body of mandible, inferior ramus Body of mandible, inferior ramus Buccal mucosa anterior to mental foramen Buccal mucosa anterior to mental foramen Anterior 2/3 tongue & floor of mouth Anterior 2/3 tongue & floor of mouth Lingual soft tissue and periosteum Lingual soft tissue and periosteum

8 Inferior Alveolar Nerve Block Indications Multiple mandibular teeth Multiple mandibular teeth Buccal anterior soft tissue Buccal anterior soft tissue Lingual anesthesia Lingual anesthesia

9 Inferior Alveolar Nerve Block Contraindications Infection/inflammation at injection site Infection/inflammation at injection site Patients at risk for self injury (eg. children) Patients at risk for self injury (eg. children)

10 Inferior Alveolar Nerve Block 10%-15% positive aspiration

11 Inferior Alveolar Nerve Block Alternatives Mental nerve block Mental nerve block Incisive nerve block Incisive nerve block Anterior infiltration Anterior infiltration

12 Inferior Alveolar Nerve Block Alternatives (cont.) Periodontal ligament injection (PDL) Periodontal ligament injection (PDL) Gow-Gates Gow-Gates Akinosi Akinosi Intraseptal Intraseptal

13 Inferior Alveolar Nerve Block Technique Apply topical Apply topical Area of insertion: Area of insertion: medial ramus, mid-coronoid notch, medial ramus, mid-coronoid notch, level with occlusal plane (1 cm above), level with occlusal plane (1 cm above), 3/4 posterior from coronoid notch to pterygomandibular raphe 3/4 posterior from coronoid notch to pterygomandibular raphe advance to bone (20-25 mm) advance to bone (20-25 mm)

14 Inferior Alveolar Nerve Block Target Area Inferior alveolar nerve, near mandibular foramen Inferior alveolar nerve, near mandibular foramen Landmarks Coronoid notch Coronoid notch Pterygomandibular raphe Pterygomandibular raphe Occlusal plane of mandibular posteriors Occlusal plane of mandibular posteriors

15 Inferior Alveolar Nerve Block Precautions Do not inject if bone not contacted Do not inject if bone not contacted Avoid forceful bone contact Avoid forceful bone contact

16 Inferior Alveolar Nerve Block Failure of Anesthesia Injection too low Injection too low Injection too anterior Injection too anterior Accessory innervation Accessory innervation -Mylohyoid nerve -Mylohyoid nerve -contralateral Incisive nerve innervation -contralateral Incisive nerve innervation

17 Inferior Alveolar Nerve Block Complications Hematoma Hematoma Trismus Trismus Facial paralysis Facial paralysis

18

19

20

21

22

23


Download ppt "Techniques of Mandibular Anesthesia. Mandibular Anesthesia Mandibular Anesthesia Lower success rate than Maxillary anesthesia - approx. 80-85 % Related."

Similar presentations


Ads by Google