[Anatomical rationale for lingual nerve injury prevention during mandibular block].
The topographic and anatomical study of lingual nerve structural features was done. It was revealed that during mandibular anesthesia possible lingual nerve injury can occur if puncture needle is lower than 1 cm. of molars occlusal surface level. The position of the lingual nerve varies withmandible movements. At the maximum open mouth lingual nerve is not mobile and is pressed against the inner surface of the mandibular ramus by the medial pterygoid muscle and the temporal muscle tendon. When closing the mouth to 1.25±0.2 cmfrom the physiological maximum, lingual nerve is displaced posteriorly from the internal oblique line of the mandible and gets mobile. On the basis of topographic and anatomic features of the lingual nervestructure the authors recommend the re-do of inferior alveolar nerve block, a semi-closed mouth position or the use the "high block techniques" (Torus anesthesia, Gow-Gates, Vazirani-Akinozi).
Central Research Institute of Dentistry and Maxillofacial Surgery, Moscow, Russia.
V A
VA
Semkin
First I.M. Sechenov First Moscow State Medical University, Department of Operative Surgery and Anatomy, Moscow, Russia.
S S
SS
Dydikin
Central Research Institute of Dentistry and Maxillofacial Surgery, Moscow, Russia.
A V
AV
Kuzin
Central Research Institute of Dentistry and Maxillofacial Surgery, Moscow, Russia.
V V
VV
Sogacheva
D000368:Aged; D000766:Anesthesia, Dental / Q000009:adverse effects*; D002102:Cadaver; D005260:Female; D006801:Humans; D061222:Lingual Nerve Injuries / Q000517:prevention & control*; D008297:Male; D008334:Mandible / Q000294:innervation*; D008340:Mandibular Nerve / Q000033:anatomy & histology*; D008875:Middle Aged; D008963:Molar / Q000033:anatomy & histology; D009407:Nerve Block / Q000009:adverse effects*; D011626:Pterygoid Muscles / Q000502:physiology