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2. INDIAN DENTAL ACADEMY
Leader in continuing dental education
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3. Mandibular Anesthesia
Lower success rate than Maxillary anesthesia approx. 80-85 %
Related to bone density
Less access to nerve trunks
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5. Mandibular Anesthesia
Most commonly performed technique
Has highest failure rate (15-20%)
Success depends on depositing solution within 1 mm
of nerve trunk
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6. 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
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8. Inferior Alveolar Nerve Block
Areas Anesthetized
Mandibular teeth to midline
Body of mandible, inferior ramus
Buccal mucosa anterior to mandibular first molar.
Anterior 2/3 tongue & floor of mouth
Lingual soft tissue and periosteum
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10. Inferior Alveolar Nerve Block
Contraindications
Infection/inflammation at injection site
Patients at risk for self injury (eg. children)
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14. 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)
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15. Inferior Alveolar Nerve Block
Target Area
Inferior alveolar nerve, near mandibular foramen
Landmarks
Coronoid notch
Pterygomandibular raphe
Occlusal plane of mandibular posteriors
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16. Inferior Alveolar Nerve Block
Precautions
Do not inject if bone not contacted
Avoid forceful bone contact
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17. Inferior Alveolar Nerve Block
Failure of Anesthesia
Injection too low
Injection too anterior
Accessory innervation
-Mylohyoid nerve
-contralateral Incisive nerve innervation
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25. Mental nerve block
It is the terminal branch of the I A N.
Comes out of mental foramen at or near the mandibular premolars.
Area suppiled:
sensory innervations to the buccal soft tissues lying
anterior to the foramen.
Soft tissues of the lower lip & the chin.
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28. Indication:
•
•
Soft tissues biopsy
Suturing of soft tiissues
Contraindications:actue inflammation at site of injection.
Advantages:1)high success rate .
2)easy technically.
3)atraumatic.
Disadvantage: hematoma
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29. Chances of positive aspiration:5.7%
Alternatives:
Technique:
foramen
25-27gauge niddle
Area of insertion :mucobuccal fold at or just anterior to the mental
Target area : mental nerve as it exist from foramen
Land mark : mandibular premolars & mucobuccal fold.
Orientation of the bevel : towards the bone.
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35. INCISIVE NERVE BLOCK
Incisive nerve:
Terminal branch of the I. A .N.
Originates as a direct continuation of the I.A .N at the mental
foramen& continues anteriorly in the incisive canal.
Area suppied: premolars ,canines,incisors & there buccal soft tissue
and bone
It provide sensory innervation to those teeth located anterior to the
mental foramen.
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37. Indication of Incisive nerve block:
1)dental procedures requiring pulpal anesthesia on the
mandibular teeth anterior to mental foramen.
2)while treating premolar to premolar
Contra indication: acute inflammation,
Area anesthetized:
Buccal mucosa anterior to the mental foramen
Lower lip &skin of the chin.
Pulpal nerve fibers of premolars,canines, anteriors.
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38. Advantage:
1)provides pulpal and hard tissue anesthesia with out lingual
anesthesia.
2)used in case of bilateral I.A.N
3)high succes rate
Disadvantage:
1)Dose not provide lingual anasthesia
2) Partial anasthesia may develop at the mid line because of
nervefibers mayover lap with opposite side
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40. Technique:
1)25-gague needle is recommended but most commonly we use 27
gague needle.
2)area of insertion:mucobuccal at or just anterior to the mental
foramen.
3)target area:mental foramen through whichthe mental nerve exit
and in which Incisive nerve is located.
4)land mark:mandibular premolars and mucobuccal flod.
5)orientation of the bevel: towards the bone.
Procedure:
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