mandibular nerve block

Techniques of Mandibular Anesthesia

Mandibular Anesthesia
Lower success rate than Maxillary anesthesia - approx. 80-85 Related to bone density Less access to nerve trunks
Mandibular Nerve Blocks
Inferior alveolar Mental - Incisive Buccal Lingual Gow-Gates Akinosi
Mandibular Anesthesia
Most commonly performed technique Has highest failure rate (15-20) Success depends on depositing solution within 1 mm of nerve trunk

Inferior Alveolar Nerve Block

Not a complete mandibular nerve block. Requires supplem1AQaq2B 3Rbr
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Inferior Alveolar Nerve Block
Nerves anesthetized Inferior Alveolar Mental Incisive Lingual
Inferior Alveola
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 Buccal
Inferior Alveolar Nerve Block
Contraindications Infection/inflammation at injection site Patients at risk for self injury (eg. children)
Inferior Alveolar Nerve


10-15 positive aspiration
Inferior Alveolar Nerve Block
Alternatives Mental nerve block Incisive nerve block Anterior infiltration
Inferior Alveolar Nerve Block
Alternatives (cont.) Periodontal ligament injection (PDL) Gow-Gates Akinosi I
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Techniques of Mandibular Anesthesia
Mandibular Anesthesia
Lower success rate than Maxillary anesthesia - approx. 80-85 Related to bone density Less access to nerve trunks
Mandibular Nerve Blocks
Inferior alveolar Mental - Incisive Buccal Lingual Gow-Gates Akinosi
Mandibular Anesthesia
Most commonly performed technique Has highest failure rate (15-20) Success depends on depositing solution within 1 mm of nerve trunk

Inferior Alveolar Nerve Block

Not a complete mandibular nerve block. Requires supplemental buccal nerve block May require infiltration of incisors or mesial root of first molar
Inferior Alveolar Nerve Block
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 Buccal anterior soft tissue Lingual anesthesia
Inferior Alveolar Nerve Block
Contraindications Infection/inflammation at injection site Patients at risk for self injury (eg. children)
Inferior Alveolar Nerve Block
10-15 positive aspiration
Inferior Alveolar Nerve Block
Alternatives Mental nerve block Incisive 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 Avoid forceful bone contact
Inferior Alveolar Nerve Block
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
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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 Avoid forceful bone contact
Inferior Alveolar Nerve Block
Failure of Anesthesia Injection too low Injection too anterior Accessory innervation -Mylohyoid nerve -contralateral Incisive nerve innervation
Techniques of Mandibular Anesthesia
Mandibular Anesthesia
Lower success rate than Maxillary anesthesia - approx. 80-85 Related to bone density Less access to nerve trunks
Mandibular Nerve Blocks
Inferior alveolar Mental - Incisive Buccal Lingual Gow-Gates Akinosi
Mandibular Anesthesia
Most commonly performed technique Has highest failure rate (15-20) Success depends on depositing solution within 1 mm of nerve trunk


Inferior Alveolar Nerve Block
Not a complete mandibular nerve block. Requires supplemental buccal nerve block May require infiltration of incisors or mesial root of first molar
Inferior Alveolar Nerve Block
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 Buccal anterior soft tissue Lingual anesthesia
Inferior Alveolar Nerve Block
Contraindications Infection/inflammation at injection site Patients at risk for self injury (eg. children)
Inferior Alveolar Nerve Block
10-15 positive aspiration
Inferior Alveolar Nerve Block
Alternatives Mental nerve block Incisive 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 Avoid forceful bone contact
Inferior Alveolar Nerve Block
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
Click to edit Master title style
Click to edit Master text styles Second Level Third Level Fourth Level Fifth Level
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Inferior Alveolar Nerve Block
Complications Hematoma Trismus Facial paralysis