What is Inferior Alveolar Nerve Block (IANB) ? The IANB, commonly referred to as the mandibular nerve block, which is the most commonly us...
What is Inferior Alveolar Nerve Block (IANB) ?
The IANB, commonly referred to as the mandibular nerve block, which is the most commonly used after infiltration and undoubtedly the most important injection technique in dentistry. Unfortunately, it also the highest failing injection technique even we correctecly injected. It is very useful for extracting multiple teeth from one quadrant. The buccal nerve block given as supplemental for anesthesing the soft tissue in the posterior buccal region.
Nerves Anesthetized
Inferior Alveolar Nerve which is the branch of the posterior division of the mandibular division of the trigeminal nerve (V3), Lingual Nerve, Mental Nerve, Incisive Nerve.
Region Anesthetized
Mandibular teeth to the midline of the given side
Anterior two-thirds of the tongue
Floor of the oral cavity
Lingual soft tissues
Body of mandible
Inferior portion of the ramus
Mucous membrane anterior to mental foramen
Technique of Injecting IANB
25 Gauge long needle is recommended for the adult patient or any paediatric patient where the soft tissue depth at the injection site is approximately 20 mm.
Area of insertion
The posterior border of the mandibular ramus can be approximated intraorally by use of the pterygomandibular raphe.
Target area
Inferior alveolar Nerve
Landmarks for inserting needle
Occlusal plane of the mandibular posterior teeth
Pterygomandibular raphe
coronoid notch
Needle orientation - Bevel should face the bone
Steps:-
1) The finger (thumb) should be placed in the Coronoid notch and imaginaryline extend posteriorly till you feel pterygomandibular raphae and this line should be parallel to occlusal plane of mandibular molar.
2) The injection should placed in the corner of the mouth on the contralateral side near to premolar.
3) Now the needle is inserted nearly 2/3 of its length can penetrate until you feel bony resistance and the needle tip should be short of 1mm or at the tip of mandibular foremen, now gently aspirate and then start deposit the loaded LA for atleast 2-3 Minutes.
Disadvantages of IANB
Accidental penetration of needle in parotid gland and in case LA deposited may cause temporary facial palsy because of facial nerve passes in parotid gland, so, care must be taken while using this technique
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