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Inferior alveolar nerve block (direct technique). A. Shows the anatomy of the inferior alveolar nerve as it enters the mandibular foramen in the
pterygomandibular space. The lingual nerve lies superficial and medial to the inferior alveolar nerve. The coronoid notch is noted. B. The area of
anesthesia obtained with a successful inferior alveolar nerve block. Usually the lingual nerve is also blocked, which provides anesthesia to the floor of the
mouth, lingual gingiva, and the anterior two thirds of the tongue. C. The syringe should be directed from the contralateral premolar area about 1 to 1.5 cm
above the mandibular plane. It is inserted about 20 to 25 mm until bone is touched in an area above the lingula. The needle should then be withdrawn 1 to
2 mm and aspirated for blood before injecting anesthesia. The sphenomandibular ligament attaches to the lingula and prevents the anesthesia from
Source: Oral and Dental Emergencies, Tintinalli’s Emergency Medicine: A Comprehensive Study Guide, 8e
reaching the inferior alveolar nerve if the injection is too low. D. Clinical photograph of the direct technique. Note the point of injection in the
Citation:
Tintinalli JE,
Ma O, Yealy DM, Meckler
Cline DM.
Emergency
A Comprehensive
pterygomandibular
depression
justStapczynski
lateral to theJ,pterygomandibular
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8e;
2016
Available
at:
http://mhmedical.com/
Accessed:
April
29,
2017
of an inferior alveolar nerve injection. Note that the needle passes through the buccinator muscle to an area just superior to the lingula.
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