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MANDIBULAR
INJECTION
TECHNIQUES

Chinthamani Laser Dental Clinic
INFERIOR ALVEOLAR NERVE BLOCK
OTHER COMMEN NAME: MANDIBULAR BLOCK
NERVES ANESTHETISED:
1.Inferioralveolar
2.Incisive
3.Men...
INDICATIONS:
1.Multiple mand teeth in 1 quadrant
2.Buccal soft tissue anesthesia
3.Lingual soft tissue anesthesia
CONTRAIN...
ADVANTAGES:


Wide area of Anesthesia

DISADVANTAGES:








Wide area of anesthesia
Inadequate anesthesia
+ve as...
ALTERNATIVES:









Mental nerve block
Incisive nerve block
Supra periosteal injection
Gow gates mand n block
5...
TECHNIQUES





25 gauge long needle
area of insertion
target area
landmarks






Coronoid notch
Pterygomandibula...
Procedure:
 Assume the correct position







For rt IANB 8 o’clk position
For lt IANB 10 o’clk position

Position ...
HEIGHT OF THE INJECTION:
 Imaginary line
 Finger on the coronoid notch
 Needle insertion point
 Post border of mand ra...
PENETRATION DEPTH:
 Depth of penetration:20 to 25mm
 If bone is contacted soon
 If bone is not contacted
 Insert the n...
SIGNS AND SYMPTOMS:




Subjective: Tingling and numbness of the lower lip.
Subjective: Tingling and numbness of the to...
FAILURES OF ANESTHESIA:
 Deposition of anesthetic too low.
 Deposition of anesthetic too far anteriorly on ramus.
 Acce...
Incomplete anesthesia to CI & LI



Due to innervation of mylohyoid
To correct:






Supraperiosteal infiltration
...
INDIRECT MANDIBULAR TECHNIQUE OR
FISCHER 1-2-3 TECHNIQUE


Needle position:









Landmarks:
Technique:





...
BUCCAL NERVE BLOCK









Other common name: Long buccal n block or
buccinator n block
Nerves anesthetised: Buccal...




Disadvantage: Pain
+ve aspiration:0.7%
Alternatives:







Buccal infiltration
Gow gates mand n block
Vazira...
Techniques







25 gauge long needle
Area of insertion
Target area
Landmarks
Orientation of needle bevel
Procedure...
SIGNS AND SYMPTOMS:


Safety Feature:





Precautions:





Pain on insertion from striking unanesthetised periost...
MANDIBULAR NERVE BLOCK THE
GOW-GATES TECHNIQUE
OTHER COMMON NAME:THIRD DIVISION N
BLOCK,V3 NERVE BLOCK.
 Nerves anestheti...


Areas anesthetised:









Indications:







Mand teeth midline
Buccal mucoperiosteum
Ant 2/3 tongue &f...
ADVANTAGES:
 Only one injection
 High success rate (>95%)
 Min aspiration rate
 Few post inj complications
 Successfu...
+VE ASPIRATION:2%
ALTERNATIVES:


IANB & buccal n block



Vazirani-akinosi closed mouth mand block



Incisive n block...
TECHNIQUES:

25 gauge long needle

Area of insertion

Target area

Landmarks






Extra oral:
Intraoral

Orientat...
SIGNS AND SYMPTOMS:SAME AS IANB


Safety feature:
 Very low +ve aspiration rate
 Needle contacting bone & preventing ov...
THANK
YOU

Email.id:chinthamanidental@gmail.com
044-43800059 , 92 83 786 776
www.chinthamanilaserdentalclinic.com
Mandibular Injection Technique
Mandibular Injection Technique
Mandibular Injection Technique
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Mandibular Injection Technique

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We in Chinthamani Laser Dental Clinic & Implant Centre ,cover every speciality and subspeciality in dentistry so that all kind of your dental problems can be treated efficiently and effectively.
Contact us:
Chinthamani Laser Dental Clinic & Implant Centre
1/464,Mount Poonamallee High Road,
Iyyapanthangal,
Chennai-56
Phone no.044-43800059 , 92 83 786776
Email:
chinthamanidental@gmail.com,
dr_mrgvl@gmail.com
Website:
www.chinthamanilaserdentalclinic.com

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Transcript of "Mandibular Injection Technique"

  1. 1. MANDIBULAR INJECTION TECHNIQUES Chinthamani Laser Dental Clinic
  2. 2. INFERIOR ALVEOLAR NERVE BLOCK OTHER COMMEN NAME: MANDIBULAR BLOCK NERVES ANESTHETISED: 1.Inferioralveolar 2.Incisive 3.Mental 4.Lingual AREAS ANESTHETISED: 1.Mandibular teeth 2.Body of the mandible 3.Buccal mucoperiosteum 4.Ant 2/3 tongue & floor of oral cavity 5.Lingual soft tissues &periosteum
  3. 3. INDICATIONS: 1.Multiple mand teeth in 1 quadrant 2.Buccal soft tissue anesthesia 3.Lingual soft tissue anesthesia CONTRAINDICATIONS: 1.Infection 2.Very young child
  4. 4. ADVANTAGES:  Wide area of Anesthesia DISADVANTAGES:        Wide area of anesthesia Inadequate anesthesia +ve aspiration(10% to 15%) Intra oral landmarks Lingual & lower lipanesthesia Partial anesthesia-bifid an &bifid mand canals +VE ASPIRATION:10% TO 15%
  5. 5. ALTERNATIVES:         Mental nerve block Incisive nerve block Supra periosteal injection Gow gates mand n block 5.vazirani-akinosi mand n block PDL injection Intra osseous injection Intra septal injection
  6. 6. TECHNIQUES     25 gauge long needle area of insertion target area landmarks     Coronoid notch Pterygomandibular raphae Occlusal plane Orientation of needle bevel
  7. 7. Procedure:  Assume the correct position      For rt IANB 8 o’clk position For lt IANB 10 o’clk position Position of the patient-supine Locate the needle inj site 3 parameters:    > height of the injection > antpost site of injection > penetration site
  8. 8. HEIGHT OF THE INJECTION:  Imaginary line  Finger on the coronoid notch  Needle insertion point  Post border of mand ramus  Prepare the tissues:  Dry wid gauze  Topical antiseptic  Topical anesthetic ANTPOST SITE OF INJECTION
  9. 9. PENETRATION DEPTH:  Depth of penetration:20 to 25mm  If bone is contacted soon  If bone is not contacted  Insert the needle  Aspirate  Withdraw the syringe  Make the needle safe  After 20 sec upright position  Wait 3to5 mins to start dental procedure
  10. 10. SIGNS AND SYMPTOMS:    Subjective: Tingling and numbness of the lower lip. Subjective: Tingling and numbness of the tongue. Objective: No pain. SAFETY FEATURE:  Contacting bone & preventing over insertion. PRECAUTIONS:   Do not deposit la if bone is not contacted. Avoid pain.
  11. 11. FAILURES OF ANESTHESIA:  Deposition of anesthetic too low.  Deposition of anesthetic too far anteriorly on ramus.  Accessory innervation to the mandibular teeth    Incomplete pulpal anesthesia. Accessory sensory innervation (e.g. cervical accessory & mylohyoid nerves). To correct        Technique 25 gauge long needle. Retract the tongue toward midline Place the syringe & direct the needle tip Depth of penetration to bone:3-5mm. Aspirate:0.6ml in 20secs Bifid inferior alveolar nerve
  12. 12. Incomplete anesthesia to CI & LI   Due to innervation of mylohyoid To correct:      Supraperiosteal infiltration 27gauge short needle Direction of needle tip Aspirate:0.6ml in 20secs After 2-3mins start dental procedure Complications:    Hematoma Trismus Transient facial paralysis
  13. 13. INDIRECT MANDIBULAR TECHNIQUE OR FISCHER 1-2-3 TECHNIQUE  Needle position:      Landmarks: Technique:     1st position: Long buccal nerve anesthetised from the opp side 2nd position: Lingual nerve anesthetised from the same side 3rd position: Inferior alveolar nerve is anesthetised from the opp side 1st position 2nd position 3rd position Signs and symptoms
  14. 14. BUCCAL NERVE BLOCK       Other common name: Long buccal n block or buccinator n block Nerves anesthetised: Buccal Areas anesthetised: Soft tissues & periosteum buccal to mand molars Indication: Buccal softtissue anesthesia Contraindication: Infection Advantages:  High success rate  Technically easy
  15. 15.    Disadvantage: Pain +ve aspiration:0.7% Alternatives:       Buccal infiltration Gow gates mand n block Vazirani-akinosi mand n block PDL injection Intra osseous injection Intraseptal injection
  16. 16. Techniques       25 gauge long needle Area of insertion Target area Landmarks Orientation of needle bevel Procedure  Assume the correct position  Position of pt:supine  Prepare the tissues for penetration  Direct the syringe & advance the needle. Depth of penetration:2-4mm  Aspirate  Withdraw the syringe  Wait 1min & start dental procedure
  17. 17. SIGNS AND SYMPTOMS:  Safety Feature:    Precautions:    Pain on insertion from striking unanesthetised periosteum LA soln not being retained at inj site Failures of anesthesia:   Min +ve aspiration Prevent over insertion Rare Complications:  Hematoma
  18. 18. MANDIBULAR NERVE BLOCK THE GOW-GATES TECHNIQUE OTHER COMMON NAME:THIRD DIVISION N BLOCK,V3 NERVE BLOCK.  Nerves anesthetised:        Inferior alveolar n Mental Incisive Lingual Mylohyoid Auriculotemporal Buccal
  19. 19.  Areas anesthetised:        Indications:      Mand teeth midline Buccal mucoperiosteum Ant 2/3 tongue &floor oral cavity Lingual soft tissues Body of mandible Skin over zygoma Multiple procedures Buccal soft tissue anesthesia Lingual soft tissue anesthesia When conventional IANB unsuccessful Contraindications:  Trismus patient & rest same as IANB
  20. 20. ADVANTAGES:  Only one injection  High success rate (>95%)  Min aspiration rate  Few post inj complications  Successful even if bifid IAN’S & mand n’s present DISADVANTAGES:  Lingual and lower lip anesthesia  Time of onset longer 5min
  21. 21. +VE ASPIRATION:2% ALTERNATIVES:  IANB & buccal n block  Vazirani-akinosi closed mouth mand block  Incisive n block  Mental n block  Buccal n block  Supra periosteal injection  Intra osseous technique  PDL inj technique
  22. 22. TECHNIQUES:  25 gauge long needle  Area of insertion  Target area  Landmarks     Extra oral: Intraoral Orientation of bevel Procedure:                 Assume the correct position Position the patient Locate extra oral landmarks Visualize intraoral landmarks Prepare tissues at site of penetration Direct the syringe Insert the needle Align the needle with the plane Slowly advance the needle Depth of penetration:25mm Withdraw the needle 1mm Aspirate:if –ve slowly deposit 1.8ml in 60-90 secs Withdraw the syringe Request the pt to keep mouth open for 1-2mins Upright position Wait for 3-5mins before starting dental procedure
  23. 23. SIGNS AND SYMPTOMS:SAME AS IANB  Safety feature:  Very low +ve aspiration rate  Needle contacting bone & preventing over insertion  Precautions:  Do not deposit if bone is not contacted  Failures of anesthesia:  Too little volume  Anatomical difficulties  Complications:  Hematoma  Trismus  Temporary paralysis of cranial nerves iii, iv & vi.
  24. 24. THANK YOU Email.id:chinthamanidental@gmail.com 044-43800059 , 92 83 786 776 www.chinthamanilaserdentalclinic.com
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