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Mandibular nerve block (other techniques)


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Mandibular nerve block (other techniques)

  1. 1. Long Buccal Nerve Block <ul><li>Anterior branch of Mandibular nerve (V3) </li></ul><ul><li>Provides buccal soft tissue anesthesia adjacent to mandibular molars </li></ul><ul><li>Not required for most restorative procedures </li></ul>
  2. 2. Buccal Nerve Block <ul><li>Indications </li></ul><ul><li>Anesthesia required - mucoperiosteum buccal to mandibular molars </li></ul><ul><li>Contraindications </li></ul><ul><li>Infection/inflammation at injection site </li></ul>
  3. 3. Buccal Nerve Block <ul><li>Advantages </li></ul><ul><li>Technically easy </li></ul><ul><li>High success rate </li></ul><ul><li>Disadvantages </li></ul><ul><li>Discomfort </li></ul>
  4. 4. Buccal Nerve Block <ul><li>Alternatives </li></ul><ul><li>Buccal infiltration </li></ul><ul><li>Gow-Gates </li></ul><ul><li>PDL </li></ul><ul><li>Intraseptal </li></ul>
  5. 5. Buccal Nerve Block <ul><li>Technique </li></ul><ul><li>Apply topical </li></ul><ul><li>Insertion distil and buccal to last molar </li></ul><ul><li>Target - Long Buccal nerve as it passes anterior border of ramus </li></ul><ul><li>Insert approx. 2 mm, aspirate </li></ul><ul><li>Inject 0.3 ml of solution, slowly </li></ul><ul><li>25-27 gauge needle </li></ul><ul><ul><ul><li>Area of insertion:- Mucosa adjacent to most distal </li></ul></ul></ul>
  6. 6. Buccal Nerve Block <ul><ul><li>Landmarks </li></ul></ul><ul><ul><li>Mandibular molars </li></ul></ul><ul><ul><li>Mucobuccal fold </li></ul></ul>
  7. 7. Buccal Nerve Block <ul><li>Complications </li></ul><ul><li>Hematoma (unusual) </li></ul><ul><li>Positive aspiration </li></ul><ul><li>0.7 % </li></ul>
  8. 10. Mental Nerve Block <ul><li>Terminal branch of IAN as it exits mental foramen </li></ul><ul><li>Provides sensory innervation to buccal soft tissue anterior to mental foramen, lip and chin </li></ul>
  9. 11. Mental Nerve Block <ul><li>Indication </li></ul><ul><li>Need for anesthesia in innervated area </li></ul><ul><li>Contraindication </li></ul><ul><li>Infection/inflammation at injection site </li></ul>
  10. 12. Mental Nerve Block <ul><li>Advantages </li></ul><ul><li>Easy, high success rate </li></ul><ul><li>Usually atraumatic </li></ul><ul><li>Disadvantage </li></ul><ul><li>Hematoma </li></ul>
  11. 13. Mental Nerve Block <ul><li>Alternatives </li></ul><ul><li>Local infiltration </li></ul><ul><li>PDL </li></ul><ul><li>Intraseptal </li></ul><ul><li>Inferior alveolar nerve block </li></ul><ul><li>Gow Gates </li></ul>
  12. 14. Mental Nerve Block <ul><li>Complications </li></ul><ul><li>Few </li></ul><ul><li>Hematoma </li></ul><ul><li>Positive aspiration </li></ul><ul><li>5.7 % </li></ul>
  13. 19. Incisive Nerve Block <ul><li>Terminal branch of IAN      </li></ul><ul><li>Originates in mental foramen and proceeds anteriorly </li></ul><ul><li>Good for bilateral anterior anesthesia            </li></ul><ul><li>Not effective for anterior lingual anesthesia   </li></ul>
  14. 20. Incisive Nerve Block <ul><li>Nerves anesthetized </li></ul><ul><li>Incisive </li></ul><ul><li>Mental </li></ul>
  15. 21. Incisive Nerve Block <ul><li>Areas Anesthetized </li></ul><ul><li>Mandibular labial mucous membranes </li></ul><ul><li>Lower lip / skin of chin </li></ul><ul><li>Incisor, cuspid and bicuspid teeth </li></ul>
  16. 22. Incisive Nerve Block <ul><li>Indication </li></ul><ul><li>Anesthesia of pulp or tissue required anterior to mental foramen </li></ul><ul><li>Contraindication </li></ul><ul><li>Infection/inflammation at injection site </li></ul>
  17. 23. Incisive Nerve Block <ul><li>Advantages </li></ul><ul><li>High success rate </li></ul><ul><li>Pulpal anesthesia w/o lingual anesthesia </li></ul><ul><li>Disadvantages </li></ul><ul><li>Lack of lingual or midline anesthesia </li></ul>
  18. 24. Incisive Nerve Block <ul><li>Complications </li></ul><ul><li>Hematoma </li></ul><ul><li>Positive aspiration </li></ul><ul><li>5.7 % </li></ul>