The Wyman Mandibular Block

Only use 25 gauge needle – 27 or smaller give poorer results

Anatomic structures involved: Maxillary tuberosity Mandibular retromolar pad Pterygo-mandibular raphe Internal oblique ridge Lingual foramen

Wyman Block Landmarks Maxillary tuberosity is joined by the Pterygo-mandibular raphe to the Mandibular retromolar pad Insertion point is 1/2 way between the upper and lower arches, just lateral to the raphe Syringe rests on contra-lateral maxillary first bicuspid

Lingual Foramen Lies below the occlusal plane, but the traditional injection places the anaesthetic above the plane Therefore the injection may fail up to 15 – 25% of the time Wyman block places anaesthetic below the occlusal plane for 95 – 98% success

Internal oblique ridge Anterior-lingual border of the ramus Significant obstruction to needle placement Must be bypassed for effective anaesthesia

Lingual foramen Internal oblique ridge

Internal oblique ridge Lingual Foramen

Anaesthetic target area

Wyman Block Procedure Locate point of insertion Position syringe over opposite side and agitate cheek vigorously for distraction Place syringe all at once and touch bone SLOWLY inject up to one cartridge of anaesthetic

Wyman Block Notes: Patient may remain reclined Mouth does not have to be propped open during onset For buccal anaesthesia add a drop to the disto-buccal papilla (not long buccal) “Walking Drops” instead of long buccal

The Wyman Block is just one of many subjects covered in Roel Wyman’s exciting hands-on seminars. For information about seminars, locations and dates click here To register for an upcoming course click here To email Roel for further information click here