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Long Buccal Nerve Block

Anterior branch of Mandibular nerve (V3)

Provides buccal soft tissue anesthesia adjacent


to mandibular molars

Not required for most restorative procedures


Buccal Nerve Block

Indications
Anesthesia required - mucoperiosteum buccal to
mandibular molars

Contraindications
Infection/inflammation at injection site
Buccal Nerve Block

Advantages
Technically easy
High success rate

Disadvantages
Discomfort
Buccal Nerve Block

Alternatives
Buccal infiltration
Gow-Gates
PDL
Intraseptal
Buccal Nerve Block
Technique
Apply topical
Insertion distil and buccal to last molar
Target - Long Buccal nerve as it passes anterior border of ramus
Insert approx. 2 mm, aspirate
Inject 0.3 ml of solution, slowly

- 25-27 gauge needle


Area of insertion:

- Mucosa adjacent to most distal


Buccal Nerve Block

Landmarks
Mandibular molars

Mucobuccal fold
Buccal Nerve Block

Complications
Hematoma (unusual)

Positive aspiration
0.7 %
Mental Nerve Block

Terminal branch of IAN as it exits mental


foramen

Provides sensory innervation to buccal soft


tissue anterior to mental foramen, lip and
chin
Mental Nerve Block

Indication
Need for anesthesia in innervated area

Contraindication
Infection/inflammation at injection site
Mental Nerve Block

Advantages
Easy, high success rate
Usually atraumatic

Disadvantage
Hematoma
Mental Nerve Block

Alternatives
Local infiltration
PDL
Intraseptal
Inferior alveolar nerve block
Gow Gates
Mental Nerve Block

Complications
Few
Hematoma

Positive aspiration
5.7 %
Incisive Nerve Block

Terminal branch of IAN


Originates in mental foramen and proceeds
anteriorly

Good for bilateral anterior anesthesia

Not effective for anterior lingual anesthesia


Incisive Nerve Block

Nerves anesthetized
Incisive

Mental
Incisive Nerve Block

Areas Anesthetized
Mandibular labial mucous membranes

Lower lip / skin of chin

Incisor, cuspid and bicuspid teeth


Incisive Nerve Block

Indication
Anesthesia of pulp or tissue required anterior to mental
foramen

Contraindication
Infection/inflammation at injection site
Incisive Nerve Block

Advantages
High success rate
Pulpal anesthesia w/o lingual anesthesia

Disadvantages
Lack of lingual or midline anesthesia
Incisive Nerve Block

Complications
Hematoma

Positive aspiration
5.7 %