Inferior Alveolar Nerve Block

The nerves anesthetized are the inferior alveolar, the incisive, the mental and the lingual nerves.  The areas anesthetized are the mandibular teeth, half arch, from the molars to the midline, the body of the mandible, the inferior portion of the ramus, the buccal mucoperiosteum, the mucous membrane anterior to the mandibular 1st molar, the anterior 2/3 of the tongue, the floor of the oral cavity, and the lingual soft tissue and periosteum.  The landmarks are the greatest concavity of the coronoid notch, the pterygomandibular raphe and the occlusal plane of the mandibular posterior teeth.  The syringe position requires placing the barrel at the corner of the mouth, usually over the bicuspids.  A finger in the coronoid notch indicates the height of insertion.  Draw an imaginary line extending horizontally through the coronoid notch, parallel with the mandibular occlusal plane and vertically 2/3 the distance between the coronoid notch and the posterior border of the ramus.

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