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Surgery presentation

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Surgery presentation

  1. 1. Anesthetic techniques on the lower jaw By Ahmed Nazar Khaleel U.G Code 1404003
  2. 2. Types of Mandibular Regional Anesthesia • Inferior Alveolar Nerve Block Mandibular teeth on side of injection, buccal and lingual hard and soft tissue, lower lip • Buccal Nerve Block Buccal soft tissue of molar region • Mental Nerve Block Buccal soft tissue anterior to mental foramen, lower lip, chin • Incisive Nerve Block Premolars, canine and incisors, lower lip, skin over the chin, buccal soft tissue anterior to the mental foramen
  3. 3. Inferior Alveolar Nerve Block • The inferior alveolar nerve block is one of the most commonly employed techniques in mandibular regional anesthesia. • It is extremely useful when multiple teeth in one quadrant require treatment. While effective, this technique carries a high failure rate even when strict adherence to protocol is maintained. • The target for this technique is the mandibular nerve as it travels on the medial aspect of the ramus, prior to its entry into the mandibular foramen. The lingual, mental, and incisive nerves are also anesthetized. • A 25 gauge long needle is preferred for this technique.
  4. 4. Technique Height of injection 6-10mm above the occlusal plane of the mandibular teeth , Area of injection from cotralateral premolar region , Advance needle slowly until it touches the bone However, we still need to block the long buccal nerve , The Long Buccal Nerve provides innervation to the buccal soft tissues and periosteum adjacent to the mandibular molars.
  5. 5. A: Location of the inferior alveolar nerve. B: After contacting bone, the needle is redirected posteriorly by bringing the barrel of the syringe towards the occlusal plane. The needle is then advanced to three quarters of its depth
  6. 6. C: Location of the lingual nerve which is anesthetized during the administration of an inferior alveolar nerve block
  7. 7. Buccal Nerve Block • The buccal nerve block, otherwise known as the long buccal or buccinator block, is a useful adjunct to the inferior alveolar nerve block when manipulation of the buccal soft tissue in the mandibular molar region is indicated. • The target for this technique is the buccal nerve as it passes over the anterior aspect of the ramus. • Contraindications to the procedure include acute inflammation and infection over the site of injection. • A 25 gauge long needle is preferred for this technique.
  8. 8. Technique Insert parallel to the occlusal plane , distal to the second Molar
  9. 9. A:Location of the buccal nerve. B: The tissue just distal and buccal to the last molar tooth is the target area for injection.
  10. 10. Mental Nerve Block • The mental nerve block is indicated for procedures where manipulation of buccal soft tissue anterior to the mental foramen is necessary. • Contraindications to this technique are acute inflammation and infection over the injection site. • A 25 or 27 gauge short needle is preferred for this technique.
  11. 11. Technique Insert the needle along the lower gum line into the buccal fold between the premolar teeth
  12. 12. A: Location of the mental and incisive nerves. B: Block of the mental and incisive nerves: The needle is inserted at the height of the mucobuccal fold over the mental foramen for both the mental nerve block and incisive nerve block.
  13. 13. Incisive Nerve Block • The incisive nerve block is not as frequently employed in clinical practice however it proves very useful when treatment is limited to mandibular anterior teeth and full quadrant anesthesia is not necessary. • The technique is almost identical to the mental nerve block with one additional step. Both the mental and incisive nerves are anesthetized using this technique. • Contraindications to this technique are acute inflammation and infection at the site of injection. • A 25 or 27 gauge short needle is preferred for this technique.
  14. 14. Technique Incisive n.Block (between lateral Incisor&canine)
  15. 15. THE END Thank You Ahmed Nazar 1404003

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