Professional Documents
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Anesthesia
Mandibular Anesthesia
Inferior alveolar
Mental - Incisive
Buccal
Lingual
Gow-Gates
Akinosi
Mandibular Anesthesia
Nerves anesthetized
Inferior Alveolar
Mental
Incisive
Lingual
Inferior Alveolar Nerve Block
Areas Anesthetized
Mandibular teeth to midline
Body of mandible, inferior ramus
Buccal mucosa anterior to mental foramen
Anterior 2/3 tongue & floor of mouth
Lingual soft tissue and periosteum
Inferior Alveolar Nerve Block
Indications
Multiple mandibular teeth
Lingual anesthesia
Inferior Alveolar Nerve Block
Contraindications
Infection/inflammation at injection site
Alternatives
Mental nerve block
Anterior infiltration
Inferior Alveolar Nerve Block
Alternatives (cont.)
Periodontal ligament injection (PDL)
Gow-Gates
Akinosi
Intraseptal
Inferior Alveolar Nerve Block
Technique
Apply topical
Area of insertion:
medial ramus, mid-coronoid notch,
level with occlusal plane (1 cm above),
3/4 posterior from coronoid notch to
pterygomandibular raphe
advance to bone (20-25 mm)
Inferior Alveolar Nerve Block
Target Area
Inferior alveolar nerve, near mandibular foramen
Landmarks
Coronoid notch
Pterygomandibular raphe
Occlusal plane of mandibular posteriors
Inferior Alveolar Nerve Block
Precautions
Do not inject if bone not contacted
Failure of Anesthesia
Injection too low
Injection too anterior
Accessory innervation
-Mylohyoid nerve
-contralateral Incisive nerve innervation
Inferior Alveolar Nerve Block
Complications
Hematoma
Trismus
Facial paralysis