Anatomy of dental anesthesia injection sites

types of dental injections
supraperiosteal (infiltration) injections

block injections

anterior superior alveolar nerve injection site
just boave root tip of canine

anterior superior alveolar nerve area anesthetized
incisors and canine

Middle superior alveolar nerve injection site
above root tips of the first premolar

middle superior alveolar nerve area anesthetized?
premolars and anterior root of 1stmolar

posterior superior alveolar nerve injection site
above root tips of 3rd molar

posterior superior alveolar nerve area anesthetized
2nd and 3rd molars and posterior roots of 1st molar

maxillary arch block injections
infraorbital

maxillary

greater palatine

nasopalatine

posterior superior alveolar

infraorbital nerve block injection site
infraorbital foramen

infraorbital nerve block area anesthetized
incisors, canine, premolars and anterior root of 1st molar

labial-buccal gingiva from midline to 1st molar

infraorbital nerve gives off
anterior and middle alveolar nerve so you can block them where they are coming off

relationship of levator labii superioris and levator anguli oris to infraorbital foramen
levator labii superioris superifical to foramen and levator anguli oris a is a deep muscle below the infraorbital formane.

infraorbital nerve and vessels sandwiched between these 2 muscles and injection must pierce these muscles

posterior superior alveolar nerve block injection site
posterior superior alveolar foramen

posterior superior alveolar nerve block area anesthetized
2nd and 3rd molars and posterior roots of 1st molar

labial-buccal gingiva of 2nd and 3rd molars and posterior 1st molar

nasopalatine nerve block injection site
incisive foramen

nasopalatine nerve block area anesthetized
primary hard palate

lingual gingival of incisors and canine

greater palatine is a branch of
V2

greater palatine nerve block injection site
greater palatine foramen

greater palatine nerve block area anesthetized
secondary hard palate

lingula gingiva from 3rd molar forward to canine

Maxillary nerve block injection site
pterygopalatine fossa via the greater palatine foramen and canal

Maxillary nerve block area anesthetized
half of upper arch teeth, half of the labial-buccal and lingual gingiva and half of the hard and soft palate

mandibular arch infiltration injections
with the exception of young children and the mandibular incisors of adults, mandibular infiltration injections are not effective because the mandibular teeth are surrounded by thicker bone that inhibits diffusion of anesthetic solution

standard inferior alveolar nerve block injection site

standard inferior alveolar nerve block injection site area anesthetized
half of the mandibular arch teeth( all of mandi teeth in the quadrant)

buccal gingiva from midline back to 1st molar

anatomical landmarks for standard inferior alveolar nerve block
coronoid process

retromolar fossa

temporal crest

lingula

mandibular foramen

sphenomandibular ligament (needle pierce above this ligament)

pterygomandibular raphe

pterygomandibular triangle(injectionsite is down in the apex of the triangle through the buccinator muscle)

pterygomandibular raphe
a tendinous thickening of the buccopharyngeal fascia, separating and giving origin to the buccinator muscle anteriorly and the superior constrictor of the pharynx posteriorly.

pterygomandibular triagle
lateral- ramus of mandible (temporal crest)

medial- pterygomandibular raphe

base of triangle- maxilla

path of need for inferior alveolar nerve block
penetrates the buccinator just lateral to the pterygomandibular raphe and then passes along the medial surface of the ramus of the mandible (just lateral to the medial pterygoid) to reach the inferior alveolar nerve

possible complications in inferior alveolar nerve block
anesthetic in parotid- temporary facial nerve paraylysis

anesthetic in msucle- trismus

possible damage to shepnomandibular ligament(you are supposed to inject above this ligament)

Lingual nerve block injection site
tissue adjacent to lingual side of roots of the 3rd molar

lingual nerve area anesthetized
lingual gingival of mandibular arch

to anesthetize both lingual and inferior alveolar nerve inject at
mandibular foramen and 5-10mm anterior to the madinbular foramen

which will anesthetize

half of mandibular arch teeth, lingual gingiva of amdnibular arch and buccal gingiva from midline back to 1st molar

mental nerve block injection site
mental foramen

mental nerve block area anesthetize
incisors, canine and premolars

buccal gingnival from midline back to 1st molar

long buccal nerve is a branch of
V3

long buccal nerve injection site
tissue adjcacent to buccal side of roots of 3rd molar

long buccal nerve area anesthetized
buccal gingiva of molars

path of need for inferior alveolar nerve block

standard inferior alveolar nerve block injection site
mandibular foramen

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