1. The Wyman
Mandibular Block

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

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

4. 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

5. 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

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

7. Lingual foramen
Internal oblique ridge

8. Internal oblique ridge
Lingual Foramen

9. Anaesthetic
target area

10. 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

15. 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

16. 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 Roel for further information click here