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Inferior alveolar nerve block (abbreviated to IANB, and also termed inferior alveolar nerve anesthesia or inferior dental block) is a nerve block technique which induces anesthesia (numbness) in the areas of the mouth and face innervated by one of the inferior alveolar nerves which are paired on the left and right side.
Both regional block and infiltration techniques are considered the first choice injections for anaesthetising the mandibular teeth. Different techniques are chosen based on different factors: Patient age [5] Infiltration anaesthesia is a preferable method to anaesthetise deciduous/primary teeth in children.
Anaesthetic injected near the mandibular foramen to block the inferior alveolar nerve and the nearby lingual nerve (supplying the tongue). This causes loss of sensation on the same side as the block to: the teeth (inferior alveolar nerve block) the lower lip and chin (mental nerve block) front two-thirds of the tongue (lingual nerve block).
Insufficient anaesthesia – usually happens due to injection to the blood vessels or injections in inflamed tissues. Avoid injection into the blood vessels by using the aspirating technique. If the tissues around are inflamed, try depositing solution at a distance or give a block injection. [5]
Due to its high vascularity, injections into the pterygomandibular space carry a high risk of intravascular injection (injecting into a blood vessel). [4] Another possible complication of an inferior alveolar nerve block occurs when the needle is placed too deep, passing through the pterygomandibular space and into the parotid gland behind.
The injection site is distal and buccal to the third molar, with the needle penetrating 1-2mm as the nerve lies directly below the mucosa. [5] A buccal nerve block is carried out after an inferior alveolar nerve block for specific procedures, such as extraction of mandibular molar teeth.
Nerve blocks are commonly used in dentistry, when the mandibular nerve is blocked for procedures on the lower teeth. With larger diameter nerves (such as the interscalene block for upper limbs or psoas compartment block for lower limbs) the nerve and position of the needle is localized with ultrasound or electrical stimulation.
The mylohyoid nerve is a mixed (motor-sensory) [1] branch of the inferior alveolar nerve (which is a branch of the mandibular nerve (CN V 3) that is itself a branch of the trigeminal nerve (CN V)). [2] [1] It arises just before it enters the mandibular foramen. [1]