Prof. Ragab Shaaban Text book Contemporary Oral and Maxillofacial surgery Peterson-Hupp.
بســم اللَـــه الرحمــن الرحيـــم. Prof.Dr.Ragab Shaaban.
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Transcript of بســم اللَـــه الرحمــن الرحيـــم. Prof.Dr.Ragab Shaaban.
![Page 1: بســم اللَـــه الرحمــن الرحيـــم. Prof.Dr.Ragab Shaaban.](https://reader035.fdocuments.in/reader035/viewer/2022062313/56649c9c5503460f9495ba3f/html5/thumbnails/1.jpg)
ــه الَلـ� بســمالرحيـــم الرحمــن
![Page 2: بســم اللَـــه الرحمــن الرحيـــم. Prof.Dr.Ragab Shaaban.](https://reader035.fdocuments.in/reader035/viewer/2022062313/56649c9c5503460f9495ba3f/html5/thumbnails/2.jpg)
Prof.Dr.Ragab Shaaban
![Page 3: بســم اللَـــه الرحمــن الرحيـــم. Prof.Dr.Ragab Shaaban.](https://reader035.fdocuments.in/reader035/viewer/2022062313/56649c9c5503460f9495ba3f/html5/thumbnails/3.jpg)
Local Analgesia In Dentistry
![Page 4: بســم اللَـــه الرحمــن الرحيـــم. Prof.Dr.Ragab Shaaban.](https://reader035.fdocuments.in/reader035/viewer/2022062313/56649c9c5503460f9495ba3f/html5/thumbnails/4.jpg)
Maxillary nerve block
Intraoral approach
![Page 5: بســم اللَـــه الرحمــن الرحيـــم. Prof.Dr.Ragab Shaaban.](https://reader035.fdocuments.in/reader035/viewer/2022062313/56649c9c5503460f9495ba3f/html5/thumbnails/5.jpg)
maxillary nerve block
Nerve anesthetized. Area anesthetized. Anatomical landmarks. Indications. Technique. Symptoms of anesthesia
a- subjective b- objective
The entire maxillary nerve and all its sub-divisions peripheral to site of injection.
![Page 6: بســم اللَـــه الرحمــن الرحيـــم. Prof.Dr.Ragab Shaaban.](https://reader035.fdocuments.in/reader035/viewer/2022062313/56649c9c5503460f9495ba3f/html5/thumbnails/6.jpg)
maxillary nerve block
Nerve anesthetized. Area anesthetized. Anatomical landmarks. Indications. Technique. Symptoms of anesthesia
a- subjective b- objective
According to the technique used:
A- high tuberosity tech.
B- Greater palatine canal tech.
![Page 7: بســم اللَـــه الرحمــن الرحيـــم. Prof.Dr.Ragab Shaaban.](https://reader035.fdocuments.in/reader035/viewer/2022062313/56649c9c5503460f9495ba3f/html5/thumbnails/7.jpg)
maxillary nerve block
Nerve anesthetized. Area anesthetized. Anatomical landmarks. Indications. Technique. Symptoms of anesthesia
a- subjective b- objective
* When anesthesia
for the entire max. nerve is required for extensive surgery.
* Presence of infection.* For diagnostic or
theraputic purposes
![Page 8: بســم اللَـــه الرحمــن الرحيـــم. Prof.Dr.Ragab Shaaban.](https://reader035.fdocuments.in/reader035/viewer/2022062313/56649c9c5503460f9495ba3f/html5/thumbnails/8.jpg)
Maxillary nerve blockhigh tub. Tech. Greater palatine canal tech.
![Page 9: بســم اللَـــه الرحمــن الرحيـــم. Prof.Dr.Ragab Shaaban.](https://reader035.fdocuments.in/reader035/viewer/2022062313/56649c9c5503460f9495ba3f/html5/thumbnails/9.jpg)
Extraoral maxillary block technques
A- infraorbital nerve block
B- maxillary nerve block
![Page 10: بســم اللَـــه الرحمــن الرحيـــم. Prof.Dr.Ragab Shaaban.](https://reader035.fdocuments.in/reader035/viewer/2022062313/56649c9c5503460f9495ba3f/html5/thumbnails/10.jpg)
Infraorbital nerve block
Extraoral technique
![Page 11: بســم اللَـــه الرحمــن الرحيـــم. Prof.Dr.Ragab Shaaban.](https://reader035.fdocuments.in/reader035/viewer/2022062313/56649c9c5503460f9495ba3f/html5/thumbnails/11.jpg)
Infraorbital nerve block
Nerve anesthetized. Area anesthetized. Anatomical landmarks. Indications. Technique. Symptoms of
anesthesia
a- subjective b- objective
1 2 3
4
![Page 12: بســم اللَـــه الرحمــن الرحيـــم. Prof.Dr.Ragab Shaaban.](https://reader035.fdocuments.in/reader035/viewer/2022062313/56649c9c5503460f9495ba3f/html5/thumbnails/12.jpg)
Infraorbital nerve block
![Page 13: بســم اللَـــه الرحمــن الرحيـــم. Prof.Dr.Ragab Shaaban.](https://reader035.fdocuments.in/reader035/viewer/2022062313/56649c9c5503460f9495ba3f/html5/thumbnails/13.jpg)
Maxillary nerve block
Extraoral technique
![Page 14: بســم اللَـــه الرحمــن الرحيـــم. Prof.Dr.Ragab Shaaban.](https://reader035.fdocuments.in/reader035/viewer/2022062313/56649c9c5503460f9495ba3f/html5/thumbnails/14.jpg)
Maxillary nerve block
Nerve anesthetized. Area anesthetized. Anatomical landmarks. Indications. Technique. Symptoms of anesthesia
a- subjective b- objective
For extensive surgery. For all divisions with minimum amount of LA. When it is difficult to anesthetize a terminal branch. Diagnostic & theraputic reasons.
![Page 15: بســم اللَـــه الرحمــن الرحيـــم. Prof.Dr.Ragab Shaaban.](https://reader035.fdocuments.in/reader035/viewer/2022062313/56649c9c5503460f9495ba3f/html5/thumbnails/15.jpg)
Landmarks
12
3 4
1
![Page 16: بســم اللَـــه الرحمــن الرحيـــم. Prof.Dr.Ragab Shaaban.](https://reader035.fdocuments.in/reader035/viewer/2022062313/56649c9c5503460f9495ba3f/html5/thumbnails/16.jpg)
Technique
![Page 17: بســم اللَـــه الرحمــن الرحيـــم. Prof.Dr.Ragab Shaaban.](https://reader035.fdocuments.in/reader035/viewer/2022062313/56649c9c5503460f9495ba3f/html5/thumbnails/17.jpg)
Local analgesia
Mandibular techniques
![Page 18: بســم اللَـــه الرحمــن الرحيـــم. Prof.Dr.Ragab Shaaban.](https://reader035.fdocuments.in/reader035/viewer/2022062313/56649c9c5503460f9495ba3f/html5/thumbnails/18.jpg)
Techniques of regional analgesia for the mandibular nerve & its subdivisions
A- intraoral techniques
![Page 19: بســم اللَـــه الرحمــن الرحيـــم. Prof.Dr.Ragab Shaaban.](https://reader035.fdocuments.in/reader035/viewer/2022062313/56649c9c5503460f9495ba3f/html5/thumbnails/19.jpg)
Nerve supply of the mandible
![Page 20: بســم اللَـــه الرحمــن الرحيـــم. Prof.Dr.Ragab Shaaban.](https://reader035.fdocuments.in/reader035/viewer/2022062313/56649c9c5503460f9495ba3f/html5/thumbnails/20.jpg)
• Inferior alveolar nerve block
![Page 21: بســم اللَـــه الرحمــن الرحيـــم. Prof.Dr.Ragab Shaaban.](https://reader035.fdocuments.in/reader035/viewer/2022062313/56649c9c5503460f9495ba3f/html5/thumbnails/21.jpg)
Inferior alveolar nerve block
Nerve anesthetized. Area anesthetized. Anatomical landmarks. . Indications Technique. Symptoms of
anesthesia
a- subjective b- objective
![Page 22: بســم اللَـــه الرحمــن الرحيـــم. Prof.Dr.Ragab Shaaban.](https://reader035.fdocuments.in/reader035/viewer/2022062313/56649c9c5503460f9495ba3f/html5/thumbnails/22.jpg)
Inferior alveolar nerve blockIndirect technique Nerve anesthetized. Area anesthetized. Anatomical landmarks. Indications. Technique. Symptoms of
anesthesia
a- subjective b- objective
Mucobuccal fold Anterior ramus of the
mandible External oplique ridge Retromolar triangle Internal oplique ridge Pterygomandibular
ligament Buccal suking pad Pterygomandibular
space
![Page 23: بســم اللَـــه الرحمــن الرحيـــم. Prof.Dr.Ragab Shaaban.](https://reader035.fdocuments.in/reader035/viewer/2022062313/56649c9c5503460f9495ba3f/html5/thumbnails/23.jpg)
Inferior alveolar nerve block
Nerve anesthetized. Area anesthetized. Anatomical landmarks. Indications. Technique. Symptoms of
anesthesia
a- subjective b- objective
*Analgesia for operative dentistry on all mand. Teeth.
*Surgery on mand. teeth & supporting structures anterior to the frist molar + lingual NB
*Surgery on mand. teeth & supporting strucures posterior to the second bicuspid +lingual NB+ buccal NB.
*Diagnostic & therputic purpose
![Page 24: بســم اللَـــه الرحمــن الرحيـــم. Prof.Dr.Ragab Shaaban.](https://reader035.fdocuments.in/reader035/viewer/2022062313/56649c9c5503460f9495ba3f/html5/thumbnails/24.jpg)
Inferior alveolar nerve block
Nerve anesthetized. Area anesthetized. Anatomical landmarks. Indications. Techniques. Symptoms of
anesthesia
a- subjective b- objective
Indirect technique. Direct technique. Gaw-Gates technique. Closed mouth technique. Extraoral technique.
![Page 25: بســم اللَـــه الرحمــن الرحيـــم. Prof.Dr.Ragab Shaaban.](https://reader035.fdocuments.in/reader035/viewer/2022062313/56649c9c5503460f9495ba3f/html5/thumbnails/25.jpg)
Inferior alveolar nerve block
Nerve anesthetized. Area anesthetized. Anatomical landmarks. Indications. Technique. Symptoms of
anesthesia
a- subjective b- objective
![Page 26: بســم اللَـــه الرحمــن الرحيـــم. Prof.Dr.Ragab Shaaban.](https://reader035.fdocuments.in/reader035/viewer/2022062313/56649c9c5503460f9495ba3f/html5/thumbnails/26.jpg)
Inferior alveolar nerve block
![Page 27: بســم اللَـــه الرحمــن الرحيـــم. Prof.Dr.Ragab Shaaban.](https://reader035.fdocuments.in/reader035/viewer/2022062313/56649c9c5503460f9495ba3f/html5/thumbnails/27.jpg)
Inferior alveolar nerve block
![Page 28: بســم اللَـــه الرحمــن الرحيـــم. Prof.Dr.Ragab Shaaban.](https://reader035.fdocuments.in/reader035/viewer/2022062313/56649c9c5503460f9495ba3f/html5/thumbnails/28.jpg)
Inferior alveolar nerve block
![Page 29: بســم اللَـــه الرحمــن الرحيـــم. Prof.Dr.Ragab Shaaban.](https://reader035.fdocuments.in/reader035/viewer/2022062313/56649c9c5503460f9495ba3f/html5/thumbnails/29.jpg)
Inferior alveolar nerve block
![Page 30: بســم اللَـــه الرحمــن الرحيـــم. Prof.Dr.Ragab Shaaban.](https://reader035.fdocuments.in/reader035/viewer/2022062313/56649c9c5503460f9495ba3f/html5/thumbnails/30.jpg)
Technique of injection
![Page 31: بســم اللَـــه الرحمــن الرحيـــم. Prof.Dr.Ragab Shaaban.](https://reader035.fdocuments.in/reader035/viewer/2022062313/56649c9c5503460f9495ba3f/html5/thumbnails/31.jpg)
III. PROPER INJECTION PROCEDURES
B- REGIONAL OR BLOCK ANESTHESIA:a- Block anesthesia in the mandible:Errors in needle insertion:1. Too high insertion: Numbness of the ear as a result of
anesthesia of the auriculotemporal nerve.
Post-injection pain & Trismus due to hitting of the insertion of the temporalis or lateral pterygoid.
![Page 32: بســم اللَـــه الرحمــن الرحيـــم. Prof.Dr.Ragab Shaaban.](https://reader035.fdocuments.in/reader035/viewer/2022062313/56649c9c5503460f9495ba3f/html5/thumbnails/32.jpg)
Post-injection pain & Trismus due to hitting of the insertion of the temporalis or
lateral pterygoid.
![Page 33: بســم اللَـــه الرحمــن الرحيـــم. Prof.Dr.Ragab Shaaban.](https://reader035.fdocuments.in/reader035/viewer/2022062313/56649c9c5503460f9495ba3f/html5/thumbnails/33.jpg)
B- REGIONAL OR BLOCK ANESTHESIA:
a- Block anesthesia in the mandible:Errors in needle insertion:1. Too high insertion: Temporary facial paralysis due to
dissemination of the solution to the branches of the facial nerve.
Double vision or temporary blindness due to dissemination of the solution through inferior orbital fissure to the lateral rectus muscle or to the optic nerve.
Haematoma in the deep temporal spaces by hitting the pterygoid venous plexus.
![Page 34: بســم اللَـــه الرحمــن الرحيـــم. Prof.Dr.Ragab Shaaban.](https://reader035.fdocuments.in/reader035/viewer/2022062313/56649c9c5503460f9495ba3f/html5/thumbnails/34.jpg)
Errors in needle insertion
1. Too low insertion:
Trismus due to trauma of the medial pterygoid.
Injection into the posterior
facial vein.
![Page 35: بســم اللَـــه الرحمــن الرحيـــم. Prof.Dr.Ragab Shaaban.](https://reader035.fdocuments.in/reader035/viewer/2022062313/56649c9c5503460f9495ba3f/html5/thumbnails/35.jpg)
B- REGIONAL OR BLOCK ANESTHESIA
a- Block anesthesia in the mandible:
Errors in needle insertion:
1. Too medial insertion: Nausea & vomiting from
dissemination of solution to the pharynx.
Dysphagea due to haematoma of the lateral pharyngeal space.
![Page 36: بســم اللَـــه الرحمــن الرحيـــم. Prof.Dr.Ragab Shaaban.](https://reader035.fdocuments.in/reader035/viewer/2022062313/56649c9c5503460f9495ba3f/html5/thumbnails/36.jpg)
Inferior alveolar nerve blockdirect technique
![Page 37: بســم اللَـــه الرحمــن الرحيـــم. Prof.Dr.Ragab Shaaban.](https://reader035.fdocuments.in/reader035/viewer/2022062313/56649c9c5503460f9495ba3f/html5/thumbnails/37.jpg)
Inferior alveolar nerve block Gaw-Gates techniqe It is considered a high mandibular block.Landmarks are :
- angle of the mouth.
- intertragic notch .
- neck of the condyle.
![Page 38: بســم اللَـــه الرحمــن الرحيـــم. Prof.Dr.Ragab Shaaban.](https://reader035.fdocuments.in/reader035/viewer/2022062313/56649c9c5503460f9495ba3f/html5/thumbnails/38.jpg)
Inferior alveolar nerve blockGow-Gates technique
![Page 39: بســم اللَـــه الرحمــن الرحيـــم. Prof.Dr.Ragab Shaaban.](https://reader035.fdocuments.in/reader035/viewer/2022062313/56649c9c5503460f9495ba3f/html5/thumbnails/39.jpg)
Inferior alveolar nerve blockGow-Gates technique
![Page 40: بســم اللَـــه الرحمــن الرحيـــم. Prof.Dr.Ragab Shaaban.](https://reader035.fdocuments.in/reader035/viewer/2022062313/56649c9c5503460f9495ba3f/html5/thumbnails/40.jpg)
Closed mouth technique(Vazirani tech.)
![Page 41: بســم اللَـــه الرحمــن الرحيـــم. Prof.Dr.Ragab Shaaban.](https://reader035.fdocuments.in/reader035/viewer/2022062313/56649c9c5503460f9495ba3f/html5/thumbnails/41.jpg)
Causes of failure of local analgesia Insuffecient knowledge of local anatomy
of the region.Faulty technique. Individual anatomical variations occuring
in different patients. Intravascular injection.Needle deflection. Inflammation.
![Page 42: بســم اللَـــه الرحمــن الرحيـــم. Prof.Dr.Ragab Shaaban.](https://reader035.fdocuments.in/reader035/viewer/2022062313/56649c9c5503460f9495ba3f/html5/thumbnails/42.jpg)
Failure of mandibular anesthsia(Anatomical variations)
![Page 43: بســم اللَـــه الرحمــن الرحيـــم. Prof.Dr.Ragab Shaaban.](https://reader035.fdocuments.in/reader035/viewer/2022062313/56649c9c5503460f9495ba3f/html5/thumbnails/43.jpg)
Causes of failure(Faulty technique)
![Page 44: بســم اللَـــه الرحمــن الرحيـــم. Prof.Dr.Ragab Shaaban.](https://reader035.fdocuments.in/reader035/viewer/2022062313/56649c9c5503460f9495ba3f/html5/thumbnails/44.jpg)
Lingual nerve block
![Page 45: بســم اللَـــه الرحمــن الرحيـــم. Prof.Dr.Ragab Shaaban.](https://reader035.fdocuments.in/reader035/viewer/2022062313/56649c9c5503460f9495ba3f/html5/thumbnails/45.jpg)
Lingual nerve block
Nerve anesthetized. Area anesthetized. Anatomical landmarks. Indications. Technique. Symptoms of
anesthesia
a- subjective b- objective
![Page 46: بســم اللَـــه الرحمــن الرحيـــم. Prof.Dr.Ragab Shaaban.](https://reader035.fdocuments.in/reader035/viewer/2022062313/56649c9c5503460f9495ba3f/html5/thumbnails/46.jpg)
Lingual nerve block
Nerve anesthetized. Area anesthetized. Anatomical landmarks. Indications. Technique. Symptoms of
anesthesia
a- subjective b- objective
The same land-marks of the inferior alveolar nerve block.
![Page 47: بســم اللَـــه الرحمــن الرحيـــم. Prof.Dr.Ragab Shaaban.](https://reader035.fdocuments.in/reader035/viewer/2022062313/56649c9c5503460f9495ba3f/html5/thumbnails/47.jpg)
Lingual nerve block
Nerve anesthetized. Area anesthetized. Anatomical landmarks. Indications. Technique. Symptoms of
anesthesia
a- subjective b- objective
For surgery on the anterior 2/3 of the tongue ,floor of the mouth and mucous membrane on the lingual side of the mandibule.
![Page 48: بســم اللَـــه الرحمــن الرحيـــم. Prof.Dr.Ragab Shaaban.](https://reader035.fdocuments.in/reader035/viewer/2022062313/56649c9c5503460f9495ba3f/html5/thumbnails/48.jpg)
Lingual nerve block
Nerve anesthetized. Area anesthetized. Anatomical landmarks. Indications. Technique. Symptoms of
anesthesia
a- subjective b- objective
![Page 49: بســم اللَـــه الرحمــن الرحيـــم. Prof.Dr.Ragab Shaaban.](https://reader035.fdocuments.in/reader035/viewer/2022062313/56649c9c5503460f9495ba3f/html5/thumbnails/49.jpg)
Lingual nerve block
![Page 50: بســم اللَـــه الرحمــن الرحيـــم. Prof.Dr.Ragab Shaaban.](https://reader035.fdocuments.in/reader035/viewer/2022062313/56649c9c5503460f9495ba3f/html5/thumbnails/50.jpg)
Lingual nerve block
Nerve anesthetized. Area anesthetized. Anatomical landmarks. Indications. Technique. Symptoms of
anesthesia
a- subjective b- objective
![Page 51: بســم اللَـــه الرحمــن الرحيـــم. Prof.Dr.Ragab Shaaban.](https://reader035.fdocuments.in/reader035/viewer/2022062313/56649c9c5503460f9495ba3f/html5/thumbnails/51.jpg)
Long buccal nerve block
![Page 52: بســم اللَـــه الرحمــن الرحيـــم. Prof.Dr.Ragab Shaaban.](https://reader035.fdocuments.in/reader035/viewer/2022062313/56649c9c5503460f9495ba3f/html5/thumbnails/52.jpg)
Long buccal nerve block
Nerve anesthetized. Area anesthetized. Anatomical landmarks. Indications. Technique. Symptoms of
anesthesia
a- subjective b- objective
![Page 53: بســم اللَـــه الرحمــن الرحيـــم. Prof.Dr.Ragab Shaaban.](https://reader035.fdocuments.in/reader035/viewer/2022062313/56649c9c5503460f9495ba3f/html5/thumbnails/53.jpg)
Long buccal nerve block
Nerve anesthetized. Area anesthetized. Anatomical landmarks. Indications. Technique. Symptoms of
anesthesia
a- subjective b- objective
External oplique ridge.
* Retromolar triangle.
![Page 54: بســم اللَـــه الرحمــن الرحيـــم. Prof.Dr.Ragab Shaaban.](https://reader035.fdocuments.in/reader035/viewer/2022062313/56649c9c5503460f9495ba3f/html5/thumbnails/54.jpg)
Long buccal nerve block
Nerve anesthetized. Area anesthetized. Anatomical landmarks. Indications. Technique. Symptoms of
anesthesia
a- subjective b- objective
External oplique ridge.
* Retromolar triangle.
![Page 55: بســم اللَـــه الرحمــن الرحيـــم. Prof.Dr.Ragab Shaaban.](https://reader035.fdocuments.in/reader035/viewer/2022062313/56649c9c5503460f9495ba3f/html5/thumbnails/55.jpg)
long buccal nerve block
Nerve anesthetized. Area anesthetized. Anatomical landmarks. Indications. Technique. Symptoms of
anesthesia
a- subjective b- objective
* Surgery on the buccal mucosa.
* To supplement the inferior alveolar nerve block.
![Page 56: بســم اللَـــه الرحمــن الرحيـــم. Prof.Dr.Ragab Shaaban.](https://reader035.fdocuments.in/reader035/viewer/2022062313/56649c9c5503460f9495ba3f/html5/thumbnails/56.jpg)
Long buccal nerve block
Nerve anesthetized. Area anesthetized. Anatomical landmarks. Indications. Technique. Symptoms of
anesthesia
a- subjective b- objective
![Page 57: بســم اللَـــه الرحمــن الرحيـــم. Prof.Dr.Ragab Shaaban.](https://reader035.fdocuments.in/reader035/viewer/2022062313/56649c9c5503460f9495ba3f/html5/thumbnails/57.jpg)
Mental nerve block
![Page 58: بســم اللَـــه الرحمــن الرحيـــم. Prof.Dr.Ragab Shaaban.](https://reader035.fdocuments.in/reader035/viewer/2022062313/56649c9c5503460f9495ba3f/html5/thumbnails/58.jpg)
Mental nerve block
Nerve anesthetized. Area anesthetized. Anatomical landmarks. Indications. Technique. Symptoms of
anesthesia
a- subjective b- objective
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Mental nerve block
Nerve anesthetized. Area anesthetized. Anatomical landmarks. Indications. Technique. Symptoms of
anesthesia
a- subjective b- objective
* Lower lip.
* mucous membrane in the mucobuccal fold anterior to the mental foramen.
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Mental nerve block
Nerve anesthetized. Area anesthetized. Anatomical landmarks. Indications. Technique. Symptoms of
anesthesia
a- subjective b- objective
For surgery on the lower lip or mucous membrane in the mucobuccal fold anterior to the mental foramen.
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Mental nerve block
Nerve anesthetized. Area anesthetized. Anatomical landmarks. Indications. Technique. Symptoms of
anesthesia
a- subjective b- objective
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Incisive nerve block
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Incisive nerve block
Nerve anesthetized. Area anesthetized. Anatomical landmarks. Indications. Technique. Symptoms of
anesthesia
a- subjective b- objective
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Incisive nerve block
Nerve anesthetized. Area anesthetized. Anatomical landmarks. Indications. Technique. Symptoms of
anesthesia
a- subjective b- objective
The same like mental nerve block.
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Incisive nerve block
Nerve anesthetized. Area anesthetized. Anatomical landmarks. Indications. Technique. Symptoms of
anesthesia
a- subjective b- objective
For anesthesia of the mandibule and labial mandibular structures anterior to the mental foramen and lower lip.
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Incisive nerve block
Nerve anesthetized. Area anesthetized. Anatomical landmarks. Indications. Technique. Symptoms of
anesthesia
a- subjective b- objective
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Extraoral mandibular block techniques
A- mental & incisive nerve blockB-inferior alveolar nerve block
C- Mandibular nerve block
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Mental & incisive nerve block
Extraoral techniques
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Mental & incisive nerve block
Nerve anesthetized. Area anesthetized. Anatomical landmarks. Indications. Technique. Symptoms of
anesthesia
a- subjective b- objective
Bicuspid teeth Lower edge of the body
of the mand Supraorbital notch Infraorbital notch Pupil of the eye
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Technique
Nerve anesthetized. Area anesthetized. Anatomical landmarks. Indications. Technique. Symptoms of
anesthesia a- subjective
b- objective
Patient looks forward An imaginary line drown
from supraorbital n.-pupil-infraorbital n., if continued downward will pass through the mental foramen
Midpoint is detected between gingival margine and lower border of the mand.
Ant.&downward insertion with gentle proping
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Inferior alveolar nerve block
Extraoral technique
Kurt Thoma
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Technique
This technique is only used when there is severe limitation of opening of the jaws as with TMJ ankylosis.
Complete asepsis should be considered.
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Technique Anteroinferior border of the
masseter is located & marketed
A line connecting it with the tragus of the ear is drown and bisected
This midpoint marks the mand. foramen externally
A line is drown down to the inferior border of the mand and parallel to the posterior border of the mand.
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Technique
Needle is inserted should be parallel to this line and of equal length
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Mandibular nerve block
Extraoral technique
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Landmarks
12
3 4
1
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Technique