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Techniques of Mandibular Anesthesia

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Presentation on theme: "Techniques of Mandibular Anesthesia"— Presentation transcript:

1 Techniques of Mandibular Anesthesia

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

3 Mandibular Nerve Blocks
Inferior alveolar Mental - Incisive Buccal Lingual Gow-Gates Akinosi

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 Mental Incisive Lingual

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

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

9 Inferior Alveolar Nerve Block
Contraindications Infection/inflammation at injection site 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 Incisive nerve block Anterior infiltration

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

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

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

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

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

17 Inferior Alveolar Nerve Block
Complications Hematoma Trismus Facial paralysis







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