Regional Nerve Blocks for Equine Dentistry

2017 ◽  
Vol 34 (2) ◽  
pp. 106-109 ◽  
Author(s):  
Molly K. Rice
Keyword(s):  
Injection Site ◽  
Oral Surgery ◽  
Inferior Alveolar Nerve ◽  
Mental Foramen ◽  
Infraorbital Nerve ◽  
Nerve Blocks ◽  
Infraorbital Foramen ◽  
Mandibular Foramen ◽  
Maxillary Nerve ◽  
Dental Procedures

Regional nerve blocks are necessary to facilitate equine oral surgery in the standing sedated patient. Step-by-step instruction on how to perform common regional nerve blocks are discussed, including infraorbital, maxillary, middle mental, and inferior alveolar nerve blocks. Regional nerve blocks are critical when performing dental procedures in the standing horse.1 The infraorbital and maxillary nerve blocks provide anesthesia of the infraorbital nerve, which is a branch of the maxillary nerve. Both nerve blocks provide adequate anesthesia for all maxillary dental procedures.1 When the infraorbital nerve block is utilized, care must be taken to advance the needle into the infraorbital foramen in order to appropriately anesthetize the caudal maxillary teeth. Mandibular dental procedures require anesthesia of the inferior alveolar nerve, which is a branch of the mandibular nerve. Local anesthesia at the level of the mental foramen will result in anesthesia of ipsilateral incisors and canines, while anesthesia at the level of the mandibular foramen will anesthetize the entire ipsilateral mandibular dental quadrant. All nerve blocks should have the injection site aseptically prepared prior to the procedure. The 4 most common dental nerve blocks are described step by step.

scholarly journals Cadaveric Evaluation of Injectate Distribution for Two Maxillary Nerve Block Techniques in Cats

2021 ◽  
Vol 8 ◽  
Author(s):  
Lily V. Davis ◽  
Naomi K. Hoyer ◽  
Pedro Boscan ◽  
Sangeeta Rao ◽  
Jennifer E. Rawlinson
Keyword(s):  
Nerve Block ◽  
Oral Surgery ◽  
Infraorbital Nerve ◽  
General Anesthetic ◽  
Nerve Blocks ◽  
Infraorbital Foramen ◽  
Maxillary Nerve ◽  
Infraorbital Canal ◽  
Significant Difference ◽  
Maxillary Nerve Block

Regional nerve blocks have been shown to decrease general anesthetic drug requirements and improve pain management in patients undergoing surgery. Regional nerve blocks are used routinely in patients undergoing oral surgery, such as dental extractions. There is little published information regarding the efficacy of feline maxillary and infraorbital nerve blocks. The goal of the study was to compare injectate distributions of the infraorbital foramen and percutaneous maxillary nerve block techniques in feline cadavers using a combined dye and radiopaque contrast media solution to simulate an injection. There was no significant difference in length of stained nerve between the two different techniques. It was not necessary to advance the needle into the infraorbital canal to achieve effective staining of the maxillary nerve. There was no significant difference in injectate distribution between two different injectate volumes, 0.2 and 0.4 ml, indicating that the smaller volume injected at the infraorbital foramen resulted in adequate nerve staining.

scholarly journals A Retrospective Study of the Incidence and Management of Complications Associated With Regional Nerve Blocks in Equine Dental Patients

2019 ◽  
Vol 36 (1) ◽  
pp. 40-45 ◽  
Author(s):  
R. Brad Tanner ◽  
John A. E. Hubbell
Keyword(s):  
Regional Anesthesia ◽  
Oral Surgery ◽  
Hospital Setting ◽  
Infraorbital Nerve ◽  
Nerve Blocks ◽  
Maxillary Nerve ◽  
Dental Patients ◽  
Management Of Complications ◽  
Facial Anatomy

Regional anesthesia of the equine head is commonly performed to allow oral extraction of diseased teeth in the standing horse. The use of 4 blocks (infraorbital nerve, maxillary nerve, mental nerve, and mandibular nerve) is well documented for desensitization of dental quadrants for oral surgery for exodontia, but descriptions of associated complications are limited. A total of 270 regional nerve blocks were performed on 162 equine patients in a second opinion referral hospital setting. Criteria for inclusion in the study included a 24-hour stay in hospital, that the blocks be performed by one clinician and at minimum, a 2-week follow-up examination be performed. A total of 8 complications were identified in 7 patients representing a 2.96% incidence of complication. Complications included supraorbital hematoma (3), local hematoma (2), lingual self-trauma (2), and nerve block failure to desensitize (1). Treatment and management of complications are discussed. Complications associated with regional anesthesia may be reduced by reducing anesthetic volumes, precise needle placement, familiarity with the facial anatomy relevant to nerve blocks, adequate restraint, aseptic technique, postprocedural muzzling, and the use of a newly opened bottle of local anesthetic.

scholarly journals The Effect of Pre-cooling the Injection Site on Pediatric Pain Perception during the Administration of Local Anesthesia

2009 ◽  
Vol 10 (3) ◽  
pp. 43-50 ◽  
Author(s):  
Naser Asl Aminabadi ◽  
Ramin Mostofi Zadeh Farahani
Keyword(s):  
Injection Site ◽  
Local Anesthesia ◽  
Local Anesthetic ◽  
Pain Perception ◽  
Pediatric Patients ◽  
Soft Tissues ◽  
Inferior Alveolar Nerve ◽  
Topical Anesthesia ◽  
Pediatric Pain ◽  
Dental Procedures

Abstract Aim The aim of the study was to evaluate the effect of cooling the soft tissue of injection sites on the pain perceptions of pediatric patients during the administration of local anesthesia for routine dental procedures. Methods and Materials A total of 160 children aged 5-6 years were included in the present study. On a random basis, the subjects were allocated to the without ice pretreatment (WIP) group (topical anesthesia + counterstimulation + distraction) or the ice pretreatment (IP) group (cooling + topical anesthesia + counterstimulation + distraction). During the administration of an inferior alveolar nerve block, the children's behavior was assessed using the sound, eye, and motor (SEM) scale. The statistical analysis of data was performed based on the analysis of variance (ANOVA). Results There were no significant differences within the groups between the values of the sound, eye, and motor components for either the WIP or the IP groups (P>0.05). All three components of the SEM in the IP group were consistently lower than the WIP group (P<0.05). Moreover, the SEM value for the WIP group surpassed the IP group (P<0.05). Conclusions Cooling the site of infiltration block prior to the injection of local anesthesia significantly reduced the pain perceived during injection of local anesthetic agent in pediatric patients. Clinical Significance Pre-cooling of the soft tissues of an injection site prior to the administration of a local anesthetic can minimize the discomfort and anxiety associated with the injection procedure and facilitates the management of pediatric patients during this phase of a dental procedure. Citation Aminabadi NA, Farahani RMZ. The Effect of Pre-cooling the Injection Site on Pediatric Pain Perception during the Administration of Local Anesthesia. J Contemp Dent Pract 2009 May; (10)3:043-050.

scholarly journals Morphometric analysis of infraorbital foramen in South Indian dry skulls

2018 ◽  
Vol 17 (4) ◽  
pp. 562-566
Author(s):  
Siddharth Tewari ◽  
Chandni Gupta ◽  
Vikram Palimar ◽  
Sneha Guruprasad Kathur
Keyword(s):  
Cleft Lip ◽  
Maxillofacial Surgery ◽  
Medical Science ◽  
Anatomical Variations ◽  
Infraorbital Nerve ◽  
Nerve Blocks ◽  
Infraorbital Foramen ◽  
South Indian ◽  
The Mean ◽  
The Right

Objective- The infraorbital foramen is located on the maxillary bone 1 cm under the infraorbital margin. Infra orbital nerve blocks are done in children for managing the postoperative pain which can occur after cleft lip operation and endoscopic sinus operation. Infraorbital nerve can also be damaged in cases of zygomatic complex fractures which are one of the most common facial injuries. So, this study was undertaken to analyze the anatomical variations by comparing various morphometric measurements of infraorbital foramen in dry skulls of adult South Indian population.Materials and methods- 60 dry skulls of unknown sex were used for the study. Various measurements and distance from various surgical landmarks were measured to evaluate the location of infraorbital foramen on both sides. Statistical Analysis was done for the above measurements mean and standard deviation, median, range, and mode were calculated.Results: The mean distance of infraorbital foramen from piriform aperture, lower end of alveolus of maxilla and infraorbital margin was 18.39, 27.88 and 7.09mm on the right and 17.89, 27.31 and 6.95mm on the left side. The mean vertical and horizontal diameter was 3.78 and 3.50mm on the right side and 3.48 and 3.35mm on the left side. In our study, the most common site of IOF in Indian skulls was found to be in line with the second premolar tooth (59.01%), followed by its position between the first and second premolar tooth (27.87%).Conclusion- These results will be helpful for surgeons while doing maxillofacial surgery and regional block anesthesia.Bangladesh Journal of Medical Science Vol.17(4) 2018 p.562-566

scholarly journals Dental intervention perspective: Anatomical Variation of Mental and Mandibular Foramen in Selected Malay Patients

2016 ◽  
Vol 15 (3) ◽  
pp. 450-454 ◽  
Author(s):  
Safar Sumit Bunyarit ◽  
Rozaida Poh Yuen Ying ◽  
Bazliah Abdul Kadir ◽  
Munirah Mohd Nizam ◽  
MM Rahman
Keyword(s):  
Anatomical Variation ◽  
Medical Science ◽  
Mental Foramen ◽  
Occlusal Plane ◽  
Mandibular Foramen ◽  
Dental Procedures ◽  
Significant Difference ◽  
Dental Intervention ◽  
The Right ◽  
Almost All

Background: Anatomical structures of head are essential to carry out almost all of dental procedures. In this regard to study the variation of mental and mandibular foramens are prerequisite for the intervention of clinical dentistry. The study was undertaken to determine the anatomical position of the mental foramen (mF) and mandibular foramen (MF) and their relationship.Methods and Methods: Eighty-seven selected Malay patients were examined at Universiti Kebangsaan Malaysia Dental Clinics in which 34 were male and 53 were female. The size and position of the mF in relation to tooth position were recorded. The size and position of the MF were recorded based on the horizontal and vertical dimensions consisting of reference point’s namely anterior and posterior border of ascending border of ramus as well as mandibular notch and lower border of mandibular ramus, respectively.Results: The mF was found to be most in line with second premolar (49%) on both sides in both sexes. The size of mF was larger on the right side and in male (p<0.05). The size of MF on the right and left side for both male and female did not differ significantly (p>0.05). The mean distance between the MF to occlusal plane was 10 mm (SD ±1.56) for both sides. There was no significant difference between mF and MF position (p>0.05).Conclusion: In the Malay population, anatomical relationship and variation between mental and mandibular foramen were not found to be significant. The information would be useful in dental intervention of the clinicians.Bangladesh Journal of Medical Science Vol.15(3) 2016 p.450-454

scholarly journals Study of Morphometric Analysis of Mandibular Foramen in Bangladeshi Dry Adult Human Mandible

2014 ◽  
Vol 11 (2) ◽  
pp. 58-61
Author(s):  
Md Mesbahul Hoque ◽  
Shamim Ara ◽  
Shahanaz Begum ◽  
AHM Mostafa Kamal ◽  
Md Abdul Momen
Keyword(s):  
Nerve Block ◽  
Inferior Alveolar Nerve ◽  
Third Molar ◽  
Anaesthetic Techniques ◽  
Anatomical Landmarks ◽  
Cross Sectional ◽  
Mandibular Foramen ◽  
Adult Human ◽  
Dental Procedures ◽  
Significant Difference

Context: Mandible is the lower jaw bone providing attachment of muscles of mastication and facial expression and provides pathway for inferior alveolar nerve and vessels. Adequate anaesthesia is a prerequisite of most of the dental procedures. Effective pain control in dentistry may be achieved by the local anaesthetic techniques; the most common procedures which are followed by the inferior alveolar nerve block. Therefore, identification of mandibular foramen is important for dental surgeons in nerve block and surgical procedures to avoid injury to neurovascular bundle. The aim of this study was to determine the position of the mandibular foramen from various anatomical landmarks. Materials and Methods: A cross sectional analytical type of study was carried out in the department of Anatomy, Dhaka Medical College, Dhaka on one hundred and eighty five (185) dry adult human mandibles of unknown sex. Position of mandibular foramen was determined using the distance of the mandibular foramen to (a) the anterior border of the ramus (b) the posterior border of the ramus (c) the mandibular notch (d) the head of the mandible (e) the posterior edge of third molar socket and (f) the symphysis menti which were measured with the help of digital sliding calipers. Results: The mandibular foramen was at the same distance from each landmark on both sides demonstrating symmetry. There was no significant difference in the values on the right and left sides of the mandibles. Conclusion: Anatomical knowledge of this study might be useful in certain surgical procedure. DOI: http://dx.doi.org/10.3329/bja.v11i2.20671 Bangladesh Journal of Anatomy, July 2013, Vol. 11 No. 2 pp 58-61

scholarly journals Regional Anesthesia for Dentistry and Orofacial Surgery in Rhesus Macaques (Macaca mulatta)

2019 ◽  
Vol 58 (2) ◽  
pp. 223-230
Author(s):  
Robyn M Engel ◽  
Marvin L Thomas ◽  
Ron E Banks
Keyword(s):  
Regional Anesthesia ◽  
Rhesus Monkeys ◽  
Rhesus Macaques ◽  
Companion Animals ◽  
Inferior Alveolar Nerve ◽  
Infraorbital Nerve ◽  
Maxillary Nerve ◽  
Correct Placement ◽  
Area Of Interest ◽  
Thiazine Dye

Regional anesthesia is a commonly used adjunct to orofacial dental and surgical procedures in companion animals and humans. However, appropriate techniques for anesthetizing branches of the mandibular and maxillary nerves have not been described for rhesus monkeys. Skulls of 3 adult rhesus monkeys were examined to identify relevant foramina, establish appropriate landmarks for injection, and estimate injection angles and depth. Cadaver heads of 7 adult rhesus monkeys (4 male, 3 female) were then injected with thiazine dye to demonstrate correct placement of solution to immerse specific branches of the mandibular and maxillary nerves. Different volumes of dye were injected on each side of each head to visualize area of diffusion, and to estimate the minimum volume needed to saturate the area of interest. After injection, the heads were dissected to expose the relevant nerves and skull foramina. We describe techniques for blocking the maxillary nerve as well as its branches: the greater palatine nerve, nasopalatine nerve, and infraorbital nerve. We also describe techniques for blocking branches of the mandibular nerve: inferior alveolar nerve, mental (or incisive) nerve, lingual nerve, and long buccal nerve. Local anesthesia for the mandibular and maxillary nerves can be accomplished in rhesus macaques and is a practical and efficient way to maximize animal welfare during potentially painful orofacial procedures.

Lingual nerve neuropathy: more than just third molar surgery and inferior alveolar nerve blocks

Dental Update ◽  
2019 ◽  
Vol 46 (8) ◽  
pp. 775-789
Author(s):  
Wei Cheong Ngeow ◽  
Wen Lin Chai
Keyword(s):  
Inferior Alveolar Nerve ◽  
Third Molar ◽  
Lingual Nerve ◽  
Third Molar Surgery ◽  
Anatomical Location ◽  
Nerve Blocks ◽  
Dental Procedures ◽  
Mandibular Third Molar ◽  
Dental Practitioners ◽  
Mandibular Third Molar Surgery

Neuropathy of the lingual nerve, when it occurs, often results from third molar surgery, or the provision of inferior alveolar nerve blocks. Investigators have reported that the anatomical location and the unpredictable course of the lingual nerve play important roles in it being affected by these procedures. However, there are many other causes of neuropathy with which most medical and dental practitioners are unfamiliar. This article briefly reviews the course of the lingual nerve, and summarizes the causes and reports of all uncommon aetiologies of neuropathy that can occur along the path of a lingual nerve. The clinical implication and management of lingual nerve neuropathy is discussed. CPD/Clinical Relevance: The reader should appreciate the importance of accurately diagnosing lingual nerve neuropathy as it can manifest from many other dental procedures and non-dental causes, apart from routine mandibular third molar surgery and local anaesthetic injections.

scholarly journals Topographical Landmarks for Identification of Inferior Alveolar Nerve and its Surgical Implications - a Cadaveric Study

2021 ◽  
Author(s):  
Ariyanachi K ◽  
Sushma P
Keyword(s):  
Nerve Block ◽  
Inferior Alveolar Nerve ◽  
Inferior Alveolar Nerve Block ◽  
Mandibular Ramus ◽  
Nerve Blocks ◽  
Mandibular Foramen ◽  
Bony Landmarks ◽  
Posterior Division ◽  
Mandibular Notch ◽  
Formalin Fixed

Abstract Background: Inferior alveolar nerve, which arises from the posterior division of the mandibular nerve, contains both sensory and motor fibres. The intraosseous course of the nerve is variable. Mandibular foramen is situated on the medial surface of the mandibular ramus. It is an important anatomical landmark for procedures like sagittal split osteotomies and inferior alveolar nerve block.Methods: The precise location of mandibular foramen was studied by the dissection of formalin fixed cadavers available for undergraduate dissection for a period of two years fron 2014-2016. Results: The mandibular foramen was 21±3.33 mm superior to the gonion at an angle of 980±50 with the base of the mandible. The mandibular foramen was 20.13±3.1 mm inferior to the lowest point of the mandibular notch. Accessory mandibular foramen was observed in 9.37% of the samples dissected.Conclusion: The present study explains the position of mandibular foramen in relation to prominent bony landmarks and the knowledge about the mandibular foramen, helps dental surgeons during inferior alveolar nerve blocks and split osteotomies.Practical implications: Failure rate of the inferior alveolar nerve block has been reported to be approximately 20-25%. A thorough anatomical knowledge of the mandibular ramus is essential for inferior alveolar nerve blocks and sagittal split osteotomies, since they are technically difficult procedures and as they are also associated with a higher incidence of complications.

scholarly journals Computed Tomography Analysis of the Feline Infraorbital Foramen and Canal

2021 ◽  
Vol 7 ◽  
Author(s):  
Lily V. Davis ◽  
Naomi K. Hoyer ◽  
Pedro Boscan ◽  
Sangeeta Rao ◽  
Jennifer E. Rawlinson
Keyword(s):  
Computed Tomography ◽  
Regional Anesthesia ◽  
Anatomic Variation ◽  
Anatomic Landmarks ◽  
Nerve Blocks ◽  
Infraorbital Foramen ◽  
Dental Procedures ◽  
Tomography Analysis

Feline skull anatomic variation is plain to see with casual observation. Obtaining an in-depth understanding of this anatomic variability is critical to performing safe and effective regional anesthesia for dental procedures and maxillofacial surgeries. Maxillofacial anatomic variability is proven to impact the placement and efficacy of nerve blocks in dogs and horses, but similar studies have not been performed in cats. This study's main objective was to evaluate the anatomy of the infraorbital foramen and canal in relation to regional anatomic landmarks in brachycephalic and mesaticephalic cats. Significant anatomic variability was identified, particularly among cats with brachycephalic skulls.

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