Indications & Technique of the Inferior Alveolar Nerve Block
a) Extraction of tooth from mandibular canine to 3rd molars
b) Endodontic surgery of lower pr molars & molars
Technique / Procedure:
1. Identify the anatomic landmarks:
- Coronoid notch
- Anterior border of ramus
- External oblique ridge
- Internal oblique ridge
- Opposite premolars
2. Before inserting needle the thumb of the left hand is passed over the buccal surface of the lower molar teeth until the external oblique ridge is felt. the tip is then rolled inwards to lie in the retro molar fossae. The midpoint of the nail should then lie in the deepest part of the Coronoid notch at the level of mandibular fossae.
3. After preparation of the mucosa, a long needle is inserted at the point.
4. With the barrel of the syringe held parallel to the mandibular occlusal plane and over the second premolar tooth of the opposite side, the needle is inserted .5cm & few drops of LA is injected to anaesthetize the lingual nerve.
5. Then the needle is advanced further 1.-2cm gently to contact the bone above the mandibular foramen & 1.5 mL of solution is deposited there.
6. The syringe is the withdrawn steadily keeping the needle straight.
7. Wait for 3 minutes for the signs of anesthesia: change of sensation in tongue & lower lip.