Ultrasound-guided Inferior Alveolar Nerve Block for Trismus in Temporomandibular Disorders: A Case Report

2020 ◽  
Author(s):  
Yuki Kojima ◽  
Ryozo Sendo ◽  
Sachi Ohno ◽  
Mitsutaka Sugimura
Keyword(s):  
Nerve Block ◽  
Dental Treatment ◽  
Temporomandibular Disorder ◽  
Inferior Alveolar Nerve ◽  
Mouth Opening ◽  
Masticatory Muscles ◽  
Inferior Alveolar Nerve Block ◽  
Ultrasound Guided ◽  
Anterior Teeth ◽  
Broad Term

Abstract Background: Temporomandibular disorder (TMD) is a broad term that encompasses pain and/or dysfunction of the masticatory musculature and TM joints (TMJs). Its most important feature is pain, followed by limited jaw movement, and joint sounds. When it progresses to a chronic condition, the symptoms are extremely difficult to manage, often requiring multiple interventions. Case presentation: Our patient, a woman in her 50s, developed TMD after a traffic accident that occurred 30 years previously. The patient presented with severe trismus due to TMJ pain (maximum mouth opening was 20 mm). She was scheduled to undergo extraction of a right lower molar and three upper anterior teeth owing to progressing caries. However, it was anticipated that the treatment would be difficult since the patient could not open her mouth adequately. Therefore, we considered relieving the trismus to facilitate dental treatment. Based on the findings, the cause of the TMD was considered to be pain in the masticatory muscles during mouth opening. Ultrasound-guided inferior alveolar nerve block (IANB) was performed on both sides using ropivacaine. Three minutes after the IANB, the pain during mouth opening disappeared and the maximum mouth opening improved to 40 mm. Dental treatment could be performed without difficulty, and the patient could maintain the mouth open throughout the treatment.Conclusions: Treatment methods for chronic TMD are limited and it is necessary to consider the exact aetiology before deciding upon a treatment option. In our case, ultrasound-guided IANB proved to be an effective modality for relieving TMD-related trismus.

scholarly journals Ultrasound-guided inferior alveolar nerve block for trismus during dental treatment: a case report

2020 ◽  
Vol 6 (1) ◽  
Author(s):  
Yuki Kojima ◽  
Ryozo Sendo ◽  
Sachi Ohno ◽  
Mitsutaka Sugimura
Keyword(s):  
Nerve Block ◽  
Dental Treatment ◽  
Temporomandibular Disorder ◽  
Inferior Alveolar Nerve ◽  
Mouth Opening ◽  
Inferior Alveolar Nerve Block ◽  
Ultrasound Guided ◽  
Case Presentation ◽  
Broad Term ◽  
Tmj Pain

Abstract Background Temporomandibular disorder (TMD) is a broad term that encompasses pain and/or dysfunction of the masticatory musculature and TM joints (TMJs). When TMD becomes a chronic condition, the symptoms are extremely difficult to manage and require multiple interventions. Case presentation A woman in her 50s developed TMD after a traffic accident 30 years ago. The patient presented with severe trismus due to TMJ pain and a maximum mouth opening of 20 mm. Ultrasound-guided inferior alveolar nerve block (IANB) was performed with ropivacaine. After IANB, the pain during mouth opening subsided and the maximum mouth opening improved to 40 mm. Dental treatment could be performed without difficulty and the patient could keep her mouth open throughout the treatment. Conclusions Treatments for chronic TMD are limited and it is necessary to identify the precise etiology before choosing a treatment option. In this patient, ultrasound-guided IANB proved to be effective in relieving TMD-related trismus.

scholarly journals RCT on the effectiveness of the intraligamentary anesthesia and inferior alveolar nerve block on pain during dental treatment

2021 ◽  
Author(s):  
Bahaa R. Youssef ◽  
Andreas Söhnel ◽  
Alexander Welk ◽  
Mohamed H. Abudrya ◽  
Mohamed Baider ◽  
...  
Keyword(s):  
Postoperative Complications ◽  
Nerve Block ◽  
Rating Scale ◽  
Dental Treatment ◽  
Inferior Alveolar Nerve ◽  
Numeric Rating Scale ◽  
Inferior Alveolar Nerve Block ◽  
Posterior Teeth ◽  
Mandibular Posterior Teeth ◽  
Numeric Rating

Abstract Objective To compare the effectiveness and complications of intraligamentary anesthesia (ILA) with conventional inferior alveolar nerve block (IANB) during injection and dental treatment of mandibular posterior teeth. Materials and methods In this randomized, prospective clinical trial, 72 patients (39 males, 33 females), scheduled for dental treatment of mandibular posterior teeth, were randomly allocated to ILA group (n = 35) received ILA injection or IANB group (n = 37) received the conventional IANB. Our primary outcome was to assess pain and stress (discomfort) during the injection and dental treatment, using the numeric rating scale (NRS) from 0 to 10 (0 = no pain, 10= the worst pain imaginable), whereas recording 24-h postoperative complications was our secondary outcomes. Results Patients in ILA group reported significantly less pain during injection when compared with IANB group (p = 0.03), while pain during dental treatment was similar in both groups (p = 0.2). Patients in both groups also reported similar law values of discomfort during treatment (p = 0.7). Although no signs of nerve contact or any other postoperative complications were observed, five patients in IANB group (none in ILA group) reported temporary irritations. Conclusion This study showed equivalent effectiveness of both intraligamentary anesthesia and conventional inferior alveolar nerve block, for pain control during routine dental treatment of mandibular posterior teeth. Nevertheless, ILA showed significantly less pain during injection. No major postoperative complications in both groups were observed. Clinical relevance ILA could be considered as an effective alternative for routine dental treatment. Trial registration NCT04563351

scholarly journals Is Inferior Alveolar Nerve Block Sufficient for Routine Dental Treatment in 4- to 6-year-old Children?

2017 ◽  
Vol 10 (4) ◽  
pp. 369-372 ◽  
Author(s):  
Milad Ghanizadeh ◽  
Maryam Pourkazemi ◽  
Sanaz Sheykhgermchi
Keyword(s):  
Nerve Block ◽  
Buccal Mucosa ◽  
Pain Control ◽  
Dental Treatment ◽  
Inferior Alveolar Nerve ◽  
Third Molar ◽  
Primary Molars ◽  
Inferior Alveolar Nerve Block ◽  
Mandibular Molars ◽  
Lower Canine

ABSTRACT Introduction Pain control is one of the most important aspects of behavior management in children. The most common way to achieve pain control is by using local anesthetics (LA). Many studies describe that the buccal nerve innervates the buccal gingiva and mucosa of the mandible for a variable extent from the vicinity of the lower third molar to the lower canine. Regarding the importance of appropriate and complete LA in child-behavior control, in this study, we examined the frequency of buccal gingiva anesthesia of primary mandibular molars and canine after inferior alveolar nerve block injection in 4- to 6-year-old children. Study design In this descriptive cross-sectional study, 220 4- to 6-year-old children were randomly selected and entered into the study. Inferior alveolar nerve block was injected with the same method and standards for all children, and after ensuring the success of block injection, anesthesia of buccal mucosa of primary molars and canine was examined by stick test and reaction of child using sound, eye, motor (SEM) scale. The data from the study were analyzed using descriptive statistics and statistical software Statistical Package for the Social Sciences (SPSS) version 21. Results The area that was the highest nonanesthetized was recorded as in the distobuccal of the second primary molars. The area of the lowest nonanesthesia was also reported in the gingiva of primary canine tooth. Conclusion According to this study, in 15 to 30% of cases, after inferior alveolar nerve block injection, the primary mandibular molars' buccal mucosa is not anesthetized. How to cite this article Pourkazemi M, Erfanparast L, Sheykhgermchi S, Ghanizadeh M. Is Inferior Alveolar Nerve Block Sufficient for Routine Dental Treatment in 4- to 6-year-old Children? Int J Clin Pediatr Dent 2017;10(4):369-372.

Herpes zoster oticus following mandibular block

2000 ◽  
Vol 114 (3) ◽  
pp. 212-213 ◽  
Author(s):  
Sangeeta Maini ◽  
Mark Preece
Keyword(s):  
Herpes Zoster ◽  
Nerve Block ◽  
Facial Palsy ◽  
Dental Treatment ◽  
Inferior Alveolar Nerve ◽  
Mandibular Nerve ◽  
Inferior Alveolar Nerve Block ◽  
Dental Surgery ◽  
Surgical Interventions ◽  
Herpes Zoster Oticus

Although a few cases of facial palsy following mandibular nerve block and dental surgery have been described, it would appear that herpes zoster oticus following dental surgery has not been documented. It is possible that the latent virus may be activated by the mandibular nerve block and dental surgical interventions. Two cases of herpes zoster oticus, both following inferior alveolar nerve block anaesthesia for dental treatment are presented.

Injectate spread in ultrasound-guided inferior alveolar nerve block: a cadaveric study

2021 ◽  
Author(s):  
Sho Kumita ◽  
Atsushi Sawada ◽  
Taka-aki Tokura ◽  
Koyo Nishiyama ◽  
Daisuke Oiwa ◽  
...  
Keyword(s):  
Nerve Block ◽  
Inferior Alveolar Nerve ◽  
Cadaveric Study ◽  
Inferior Alveolar Nerve Block ◽  
Ultrasound Guided

scholarly journals Ultrasound-Guided Inferior Alveolar Nerve Block in the Horse: Assessment of the Extraoral Approach in Cadavers

2019 ◽  
Vol 36 (1) ◽  
pp. 46-51
Author(s):  
Jessica Purefoy Johnson ◽  
Robert Karl Peckham ◽  
Conor Rowan ◽  
Alan Wolfe ◽  
John Mark O’Leary
Keyword(s):  
Methylene Blue ◽  
Nerve Block ◽  
Inferior Alveolar Nerve ◽  
Lingual Nerve ◽  
Blue Dye ◽  
Methylene Blue Dye ◽  
Inferior Alveolar Nerve Block ◽  
Success Rates ◽  
Ultrasound Guided ◽  
Dye Staining

Blinded techniques to desensitize the inferior alveolar nerve (IAN) include intraoral, angled, and vertical extraoral approaches with reported success rates of 100%, 73%, and 59%, respectively. It has not been determined whether an ultrasound-guided extraoral approach is feasible. Further, the fascicular nature of the inferior alveolar and lingual nerves of the horse has not been described. The objectives of this study were to describe a low-volume ultrasound-guided vertical extraoral inferior alveolar nerve block technique and to describe the fascicular nature of these nerves. An ultrasound-guided approach to the IAN was conducted with a microconvex transducer and an 18-G, 15-cm spinal needle using a solution containing iodinated-contrast and methylene blue dye. Accuracy was assessed by contrast visualized at the mandibular foramen on computed tomography (CT) and methylene blue dye staining of the nerves on gross dissection. Sections of inferior alveolar and lingual nerves were submitted for histological analysis. Assessment by CT and dissection determined success rates of 81.3% and 68.8%, respectively; 68.8% of injections had inadvertent methylene blue dye staining of the lingual nerve. Nerve histology revealed both the inferior alveolar and lingual nerves to be multifascicular in nature. Mean fascicle counts for the inferior alveolar and lingual nerves were 29 and 30.8, respectively. The technique is challenging and no more accurate than previously published blinded techniques. Any extraoral approach to the IAN is likely to also desensitize the lingual nerve.

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