different techniques of mandibular anesthesia

1. TECHNIQUES OF
MANDIBULAR ANESTHESUA
by Azkah Qazi

3. Mandibular teeth
Anterior teeth Incisive nerve
Posterior teeth
Inf.alveolar
nerve
Pulp
investing
tissues
Labial
(buccal)
periosteum
Anterior and
PM
MOLARS
Mental nerve
Cutaneous coli nerve
Branch of cervical
plexus C2 and C3
Long buccal nerve

4. INFERIOR ALVEOLAR NERVE
BLOCK
INDICATIONS CONTRA INDICATIONS
 Multiple teeth in one
quadrant
 Buccal soft tissue
anesthesia is necessary
(ant. to mental foramen)
 Lingual soft tissue
anesthesia is necessary
 Infection or Inflammation
 Patients who are more
likely to bite their lip or
tongue

5. INFERIOR ALVEOLAR NERVE
BLOCK
Advantages Disadvantage
 One injection provides a
wide anesthesia
 Not indicated for localized
procedures
 Positive aspiration
 Partial anesthesia possible
where a bifid inf.alv.nerve
and bifid mand canals are
present

6. BUCCAL NERVE BLOCK
Indications Contraindications
 When buccal soft tissue
anesthesia is necessary for
dental procedures
 Infection
 Acute inflammation

7. BUCCAL NERVE BLOCK
Advantages Disadvantages
 High success rate
 Techincally easy
 Potential for pain if needle
contacts the periosteum
during injection

8. GOW GATES TECHNIQUE
Indications Contraindications
 Multiple teeth in one
quadrant
 Buccal soft tissue
anesthesia is necessary
(ant. to mental foramen)
 Lingual soft tissue
anesthesia is necessary
 When IAB is unsuccessfuk
 Infection or Inflammation
 Patients who are more
likely to bite their lip or
tongue
 Patients with trismus

9. GOW GATES TECHNIQUE
Advantages Disadvantages
 One injection provides a
wide anesthesia
 High success rate
 Minimum aspiration rate
 The onset time is a bit
longer than the IANB
 Techinque is difficult
 Patients who are more
likely to bite their lip or
tongue

10. VAZIRANI AKINOSI CLOSED
MOUTH MAND BLOCK
INDICATIONS CONTRAINDICATIONS
 Limited mouth opening
 Multiple procedures on
mandibular teeth
 Landmark are difficult to
visualize
 Infection
 Inflammation
 Patients who are more
likely to bite their lip or
tongue

11. VAZIRANI AKINOSI CLOSED
MOUTH MAND BLOCK
Advantages Disadvantages
 Atraumatic
 Patient need not to be able
to open the mouth
 Fewer post op
complications
 Lower aspiration rate
 Difficult to visualize the
path of the needle and the
depth of insertion
 No bony contact
 Traumatic –if the needle is
too close to the periosteum

12. COMPLICATIONS
LOCAL SYSTEMATIC
 Needle breakage
 Facial nerve paralysis
 Trismus
 Hematoma
 Pain on injection
 Burning on injection
 Edema
 paresthesia
 Overdose
 Allergy

13. Chair positions

14.  thankyou