Long Buccal Nerve Block

Anterior branch of Mandibular nerve (V3) Provides buccal soft tissue anesthesia adjacent to mandibular molars Not required for most restorative procedures

Buccal Nerve Block

Indications Anesthesia required - mucoperiosteum buccal to mandibular molars Contraindications Infection/inflammation at injection site

Buccal Nerve Block

Advantages Technically easy High success rate Disadvantages Discomfort

Buccal Nerve Block

Alternatives Buccal infiltration Gow-Gates PDL Intraseptal

Buccal Nerve Block

Technique Apply topical Insertion distil and buccal to last molar Target - Long Buccal nerve as it passes anterior border of ramus Insert approx. 2 mm, aspirate Inject 0.3 ml of solution, slowly

Buccal Nerve Block

Landmarks Mandibular molars

Mucobuccal fold

Buccal Nerve Block

Complications Hematoma (unusual)

Positive aspiration 0.7 %

Mental Nerve Block

Terminal branch of IAN as it exits mental foramen Provides sensory innervation to buccal soft tissue anterior to mental foramen, lip and chin

Mental Nerve Block

Indication Need for anesthesia in innervated area

Contraindication Infection/inflammation at injection site

Mental Nerve Block

Advantages Easy, high success rate Usually atraumatic Disadvantage Hematoma

Mental Nerve Block

Alternatives Local infiltration PDL Intraseptal Inferior alveolar nerve block Gow Gates

Mental Nerve Block

Complications Few Hematoma Positive aspiration 5.7 %

Incisive Nerve Block

Terminal branch of IAN Originates in mental foramen and proceeds anteriorly Good for bilateral anterior anesthesia Not effective for anterior lingual anesthesia

Incisive Nerve Block

Nerves anesthetized Incisive

Mental

Incisive Nerve Block

Areas Anesthetized Mandibular labial mucous membranes

Lower lip / skin of chin

Incisor, cuspid and bicuspid teeth

Incisive Nerve Block

Indication Anesthesia of pulp or tissue required anterior to mental foramen Contraindication Infection/inflammation at injection site

Incisive Nerve Block

Advantages High success rate Pulpal anesthesia w/o lingual anesthesia Disadvantages Lack of lingual or midline anesthesia

Incisive Nerve Block

Complications Hematoma

Positive aspiration 5.7 %