Notes in anesthesia

Bones in maxilla is spongy bone so can be infiltrated in any site like above the teeth ,while
mandible is formed of compact bone so it must be infiltrated in mandibular foramen and if
anesthesia is infiltrated above the teeth in mandible it wont do anything

An in nerve block technique we block the inferior alveolar nerve before it enter the
mandibular foramen and when blocking the nerve we stop sensation of all half of the lower
arch and also we block the lingual nerve as it numb the lingual tissue of teeth and floor of
the mouth and it coincide with inferior alveolar nerve block and we numb the buccal tissue
of the three molars by long buccal nerve block

Anatomical landmarks that will help me to know the location of infiltration

contralateral premolars(junction between 4 and 5) it will help to know the direction of the )1
needle

‫انا بحط النيدل بين الفور والفايف وهي بتساعدني نحدد المكان بتاع النيدل‬

occlusal plane it will help to know the height of the needle, coronoid notch in the top of )2
external oblique ridge and I know the notch when my thumb catch in it and I infiltrate the
needle in the site of middle of my thumb

pterygomandibular raphae, we must infiltrate the needle lateral to it )3

Steps

First we put needle In contralateral premolar

Then we inject the needle in coronoid notch and lateral to raphae and we inject the 2 thirds
of the needle or the last quarter of the needle remain outside the tissue and when I inject
the needle I will feel the bone contact

Then I back the needle to the half and infiltrate the lingual nerve

And we infiltrate the long buccal nerve by inject the point distal to the last buccal cusp of
the teeth