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Questions and Answers
What is the primary purpose of the incisive nerve block?
Which technique is recommended for performing an incisive nerve block?
What percentage indicates the positive aspiration rate during nerve block procedures?
What is a common complication associated with the mandibular nerve blocks?
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When performing an incisive nerve block, which anatomical landmark is essential for locating the mental foramen?
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Which of the following is a sign of anesthesia failure during a nerve block?
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What precaution should be taken when injecting the anesthetic for an incisive nerve block?
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In which scenario would local infiltration on the buccal side of the mandibular central incisors be necessary?
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What is the appropriate depth of penetration for a mental nerve block?
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Which of the following is NOT a sign of effective anesthesia after a mental nerve block?
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What should be done if tissue at the injection site balloons during the deposition of anesthetic?
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Which area should be avoided to prevent discomfort during the mental nerve block?
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What is the primary area anesthetized by the incisive nerve block?
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What are the areas specifically anesthetized by the mental nerve block?
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Which condition is a contraindication for performing a nerve block?
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What is a minor complication that may occur during a mandibular nerve block procedure?
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Which of the following is a contraindication for performing a mental nerve block?
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Which of these is NOT an indication for performing an incisive nerve block?
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What is the most significant disadvantage associated with a mental nerve block?
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What is the recommended needle gauge for a mental nerve block procedure?
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During the mental nerve block injection, which orientation should the needle bevel take?
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Which alternative technique is NOT commonly used as an alternative to the mental nerve block?
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Which landmark is crucial in locating the mental foramen prior to injection?
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What is the likelihood of positive aspiration during a mental nerve block procedure?
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Study Notes
Incisive Nerve Block
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Technique:
- Use a 25-gauge short needle (although a 27-gauge short is more common)
- Insert in the mucobuccal fold at or just anterior to the mental foramen
- Target the mental foramen where the mental and incisive nerves are located
- Landmarks: mandibular premolars and mucobuccal fold
- Bevel of needle should be towards bone during injection
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Procedure:
- Position:
- Patient: Supine recommended, semisupine is acceptable, have patient partially close their mouth
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Locate the mental foramen:
- Place finger in mucobuccal fold, moving anteriorly until bone feels irregular and concave
- Mental foramen usually located at the apex of the second premolar but can vary
- Patient may feel soreness when finger pressure is applied
- Easier to locate using radiographs
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Prepare the tissues:
- Dry with sterile gauze
- Apply topical antiseptic
Mental Nerve Block
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Nerve Anesthetized: Mental nerve, a terminal branch of the inferior alveolar nerve
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Areas Anesthetized: Buccal mucous membranes anterior to the mental foramen to the midline and skin of the lower lip and chin
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Indications:
- Soft tissue biopsies
- Suturing of soft tissues
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Contraindication: Infection or acute inflammation at the injection site
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Advantages:
- High success rate
- Technically easy
- Usually atraumatic
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Disadvantage: Hematoma
Mental Nerve Block
-
Technique:
- Use 25- or 27-gauge short needle
- Insert in the mucobuccal fold at or just anterior to the mental foramen
- Target the mental nerve as it exits the mental foramen, usually located between the apices of the first and second premolars
- Landmarks: mandibular premolars and mucobuccal fold
- Bevel of needle should be towards bone during injection
-
Position:
- Patient: Supine recommended, semisupine is acceptable, have patient partially close their mouth
-
Locate the mental foramen:
- Place finger in mucobuccal fold, moving anteriorly until bone feels irregular and concave
- Mental foramen usually located at the apex of the second premolar but can vary
- Patient may feel soreness when finger pressure is applied
- Easier to locate using radiographs
-
Prepare the tissues:
- Dry with sterile gauze
- Apply topical antiseptic
- Apply topical anesthetic for at least 1 minute
- Pull the lower lip and buccal soft tissues laterally for greater visibility and taut tissues
- Penetrate the mucous membrane at the injection site, at the canine or first premolar, directing the syringe towards the mental foramen
- Advance the needle slowly until the foramen is reached, depth of penetration is 5 to 6 mm
- Aspirate
Mental Nerve Block (Continued)
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Procedure:
- Inject 0.6 ml (approximately one third of a cartridge) slowly over 20 seconds if aspiration is negative
- Stop the deposition and remove the syringe if tissues balloon during injection
- Withdraw the syringe and immediately make the needle safe
- Wait 2 to 3 minutes before commencing the procedure
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Signs and Symptoms:
- Subjective: Tingling or numbness of the lower lip
- Objective: No pain during treatment
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Safety: The region is anatomically "safe"
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Precautions:
- Striking the periosteum produces discomfort
- To prevent: Avoid contact with the periosteum, deposit small amount of solution before contacting the periosteum
- Failures of anesthesia: Rare with the mental nerve block
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Complications:
- Hematoma: Bluish discoloration and tissue swelling at the injection site, blood may exit the needle puncture point into the buccal fold
- To treat: Apply pressure with gauze directly to the area of bleeding for at least 2 minutes
Incisive Nerve Block
- Other common name: Mental nerve block (inappropriate)
- Nerves Anesthetized: Mental and incisive nerves
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Areas Anesthetized:
- Buccal mucous membrane anterior to the mental foramen, usually from the second premolar to the midline
- Lower lip and skin of the chin
- Pulpal nerve fibers to the premolars, canine, and incisors
Incisive Nerve Block (Continued)
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Indications:
- Dental procedures requiring pulpal anesthesia on mandibular teeth anterior to the mental foramen
- When inferior alveolar nerve block (IANB) is not indicated
- When six, eight, or ten anterior teeth are treated, the incisive nerve block is recommended in place of bilateral IANBs
- Contraindication: Infection or acute inflammation at the injection site
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Disadvantages:
- Requires careful technique to achieve adequate anesthesia
- May have limited duration of pulpal anesthesia (may be only partially effective)
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Description
This quiz covers the procedure and technique for performing an incisive nerve block, focusing on needle insertion, target location, and patient positioning. It also highlights the importance of locating the mental foramen and preparing tissues before the injection. Perfect for dental students and practitioners.
