Mandibular nerve block (other techniques)
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Long Buccal Nerve BlockLong Buccal Nerve Block
Anterior branch of Mandibular nerve (V3)Anterior branch of Mandibular nerve (V3)
Provides buccal soft tissue anesthesia adjacent to Provides buccal soft tissue anesthesia adjacent to mandibular molarsmandibular molars
Not required for most restorative proceduresNot required for most restorative procedures
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Buccal Nerve BlockBuccal Nerve Block
IndicationsIndications
Anesthesia required - mucoperiosteum Anesthesia required - mucoperiosteum buccal to mandibular molarsbuccal to mandibular molars
ContraindicationsContraindications
Infection/inflammation at injection siteInfection/inflammation at injection site
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Buccal Nerve BlockBuccal Nerve Block
AdvantagesAdvantages
Technically easyTechnically easy
High success rateHigh success rate
DisadvantagesDisadvantages
DiscomfortDiscomfort
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Buccal Nerve BlockBuccal Nerve Block
AlternativesAlternatives
Buccal infiltrationBuccal infiltration
Gow-GatesGow-Gates
PDLPDL
IntraseptalIntraseptal
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Buccal Nerve BlockBuccal Nerve BlockTechniqueTechnique
Apply topicalApply topical
Insertion distil and buccal to last molarInsertion distil and buccal to last molar
Target - Long Buccal nerve as it passes anterior border Target - Long Buccal nerve as it passes anterior border of ramusof ramus
Insert approx. 2 mm, aspirateInsert approx. 2 mm, aspirate
Inject 0.3 ml of solution, slowlyInject 0.3 ml of solution, slowly
25-27 gauge needle25-27 gauge needle
Area of insertion:- Mucosa adjacent to most distal Area of insertion:- Mucosa adjacent to most distal
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Buccal Nerve BlockBuccal Nerve Block
LandmarksLandmarks
Mandibular molarsMandibular molars
Mucobuccal foldMucobuccal fold
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Buccal Nerve BlockBuccal Nerve Block
ComplicationsComplications
Hematoma (unusual)Hematoma (unusual)
Positive aspirationPositive aspiration
0.7 %0.7 %
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Mental Nerve BlockMental Nerve Block
Terminal branch of IAN as it exits mental Terminal branch of IAN as it exits mental foramenforamen
Provides sensory innervation to buccal soft Provides sensory innervation to buccal soft tissue anterior to mental foramen, lip and tissue anterior to mental foramen, lip and chin chin
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Mental Nerve BlockMental Nerve Block
IndicationIndication
Need for anesthesia in innervated areaNeed for anesthesia in innervated area
ContraindicationContraindication
Infection/inflammation at injection siteInfection/inflammation at injection site
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Mental Nerve BlockMental Nerve Block
AdvantagesAdvantages
Easy, high success rateEasy, high success rate
Usually atraumaticUsually atraumatic
DisadvantageDisadvantage
HematomaHematoma
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Mental Nerve BlockMental Nerve Block
AlternativesAlternatives
Local infiltrationLocal infiltration
PDLPDL
IntraseptalIntraseptal
Inferior alveolar nerve blockInferior alveolar nerve block
Gow GatesGow Gates
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Mental Nerve BlockMental Nerve Block
ComplicationsComplications
FewFew
HematomaHematoma
Positive aspirationPositive aspiration
5.7 %5.7 %
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Incisive Nerve BlockIncisive Nerve Block
Terminal branch of IAN Terminal branch of IAN
Originates in mental foramen and proceeds Originates in mental foramen and proceeds anteriorlyanteriorly
Good for bilateral anterior anesthesia Good for bilateral anterior anesthesia
Not effective for anterior lingual anesthesia Not effective for anterior lingual anesthesia
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Incisive Nerve BlockIncisive Nerve Block
Nerves anesthetizedNerves anesthetized
IncisiveIncisive
MentalMental
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Incisive Nerve BlockIncisive Nerve Block
Areas AnesthetizedAreas Anesthetized
Mandibular labial mucous membranesMandibular labial mucous membranes
Lower lip / skin of chinLower lip / skin of chin
Incisor, cuspid and bicuspid teethIncisor, cuspid and bicuspid teeth
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Incisive Nerve BlockIncisive Nerve Block
IndicationIndication
Anesthesia of pulp or tissue required Anesthesia of pulp or tissue required anterior to mental foramenanterior to mental foramen
ContraindicationContraindication
Infection/inflammation at injection siteInfection/inflammation at injection site
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Incisive Nerve BlockIncisive Nerve Block
AdvantagesAdvantages
High success rateHigh success rate
Pulpal anesthesia w/o lingual anesthesiaPulpal anesthesia w/o lingual anesthesia
DisadvantagesDisadvantages
Lack of lingual or midline anesthesiaLack of lingual or midline anesthesia
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Incisive Nerve BlockIncisive Nerve Block
ComplicationsComplications
HematomaHematoma
Positive aspirationPositive aspiration
5.7 %5.7 %