Infra Orbital Nerve Block

# INFRA-ORBITAL NERVE BLOCK

 * Anatomical Landmarks:

   - supraorbital notch

   - pupil of eye

   - infraorbital notch

   - infraorbital foramen

   - muccobuccal fold

   - 1st nd 2nd premolar

   - mental foramen

* Nerves Anesthetized:

   • Infraorbital nerve

   • Anterior Superior Alveolar nerve

   • Middle Superior Alveolar nerve

   • Inferior Palpebral Nerve

   • Lateral Nasal Nerve

   • Superior Labial Nerve

 * Areas Anesthetized:

   - teeth midline to the 2nd premolar

   - buccal mucoperiosteum and bone overlying these teeth

   - lateral wall of nose, upper lip and lower eyelid

* Technique for infra-orbital nerve block :-

  * patient position :-

    - patient is supine or semisupine position on dental chair with maxiilary occlusal plane

      45°angle to the floor.

 * Operator position :-

   - for the right nerve block, operator should stand at 9 o'clock position.

   - for the left nerve block, operator should stand at 8 o'clock position.

* Injection techniques :-

 - Draw an imaginary Straight line through the following landmarks: Mental Foreman,Bicuspid Teeth infra-orbital foreman Pupils of Eyes.

- Locate the infra orbital notch with your Thumb and after palpating the finger should be

   moved downwards about 0.5 cm until a shallow depression is felt.

 - Use the index finger to retract the Lip exposing the muco buccal fold.

 - The needle should be inserted at this location at a sufficient distance (5mm) from

    the labial plate to pass over the canine fossa.

 - The Needle after insertion in the desired location should be guided with the help of the  

    thumb which was placed on the infraorbital foramen.

 - The needle should be guided into position so that it contacts the bone at the entrance

   to the foramen.

 - Make sure that the needle does not penetrate more than 3/4th Inch and use the thumb to

   prevent the needle from entering the orbital cavity.

 - 1.9 to 1.2 ml of Local anesthetic solution is deposited and Thumb is used to hold the

   needle in position till the end.

 * Symptoms of Anesthesia:

     • Objective Symptoms: Instrumentatio should be done, use either the Tip of a blunt Probe

               or Elevator to check for Objective symptoms.The anesthetized tissue and teeth

                should be pressed and tapped as compared to the other un- anesthetized site.

       • Subjective Symptoms: Tingling and numbness of the upper lip, lower eyelid and side of

                the nose on the side affected will always be present but are not necessarily an

                indication of good anesthesia.