This document discusses various nerve blocks of the mandible including the inferior alveolar nerve block, buccal nerve block, mental nerve block, and incisive nerve block. It provides details on the nerves anesthetized, areas anesthetized, indications, contraindications, landmarks, and techniques for each block. The document serves as a reference for dental practitioners on performing different mandibular nerve blocks for various dental procedures.

1. presented by
Tom thomas
2017
170020747

2.  Introduction
 Inferior alveolar nerve block
 Buccal nerve block
 Mental nerve block
 Incisive nerve block
 Reference

3.  Mandibular nerve is a branch of trigeminal nerve it divides mainly
into two branches after coming out from cranium through foramen
ovale.
 Mandibular blocks:
Inferior alveolar nerve block
Buccal nerve block
Incisive nerve block
Mental nerve block
Gow- gates mandibular nerve block
Vazirani-Akinosi nerve block

4.  Most frequently used(direct technique)
 Most important injection technique in dentistry
 Other common name: mandibular block
 Nerves anesthetized
1. Inferior alveolar
2. Incisive
3. Mental
4. Lingual

6.  Indications:Procedures on multiple mandibular teeth
in one quadrant
When Buccal soft tissue anaesthesia is
necessary
 Contraindications
 Advantage
 Disadvantage
 Area of insertion
 Target area
 Landmarks(Coronoid notch,pterygomandibular
raphe,occlusal plane of mandibular posterior teeth)
complications: hematoma, trismus, facial paralysis)
 Depth of penetration:20-25 mm

7.  Needle position in halstead approach
1. First position: inferior alveolar nerve is Anaesthetized
from the opposite side
2. Second position: lingual nerve is anaesthetized from the
opposite side
3. Third position: long buccal nerve is Anaesthetized
separate
 In indirect technique(Fischer 1-2-3)
1. First position: long buccal nerve is Anaesthetized from
the opposite side
2. Second position: lingual nerve is Anaesthetized from
the same side
3. Third position: inferior alveolar nerve is Anaesthetized
from the opposite side

8.  Nerves anesthetized
 Areas anesthetized:soft tissues and periosteum buccal to the
mandibular molar
 Indication
 Contraindication
 Advantage
 Disadvantage: Potential for pain if the needle contacts the
periosteum during injection

9.  Area of insertion : mucous membrane distal and buccal
To the most distal tooth
 Target:Long buccal nerve as it passes through anterior
border of ramus
 Landmarks: Mandibular molar and muccobuccal fold
 Depth of penetration :1-2 mm

10.  Nerves Anaesthetized
 Areas Anaesthetized:Buccal mucous membrane
anterior to the mental foramen to the midline
skin of chin ,lowerlip
 Indication:Soft tissue biopsies,suturing of soft
tissues
 Contraindication
 advantages
 Disadvantage :Hematoma

11.  Area of insertion: muccobuccal fold at Or just anterior
to the mental foramen
 Target area:Mental nerve as it exists the mental
foramen
 Landmarks: mandibular Premolars and muccobuccal
fold
 Depth of penetration:5-6mm

12.  Nerves anesthetized: Incisive,mental
 Areas anesthetized:Buccal mucous membrane anterior
To the mental foramen, usually from the second Premolar to
The midline
Lower lip and skin of the chin
Pulpal nerve fibres to the Premolars,canine and incisors
 Indication: dental procedures requiring pulpal anesthesia on
mandibular teeth anterior to the mental foramen
 Contraindication
 Advantage:Provides pulpal and hard tissue anesthesia
without lingual anesthesia
 Disadvantage
 Complications

13.  Area of insertion: Muccobuccal fold at or just anterior
to the mental foramen
 Target area:Mental Foramen through which the mental
nerve exists and inside of which the incisive nerve is
located
 Landmarks:mandibular Premolars and muccobuccal
fold
 Depth of penetration:5-6mm

14.  Handbook of local anesthesia
,Stanley.f.malamed
 Textbook of oral and maxillofacial surgery sm
balaj