AAAAA

1. Anesthetic techniques on
the lower jaw
By
Ahmed Nazar Khaleel
U.G Code 1404003

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. 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. 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. 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. C: Location of the lingual nerve which is anesthetized during the
administration of an inferior alveolar nerve block

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. Technique
Insert parallel to the occlusal plane , distal to
the second Molar

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. 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. Technique
Insert the needle along the lower gum line into
the buccal fold between the premolar teeth

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. 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. Technique
Incisive n.Block (between lateral
Incisor&canine)

15. THE END
Thank You
Ahmed Nazar 1404003