![]() ![]() Injuries to the lingual nerve (LN) and inferior alveolar nerve (IAN) are rare in the course of performing IANB (inferior alveolar nerve blocks) but have been described and attributed to direct needle insetion, chemical trauma and hematoma. This small number of fascicles in the proximal segment of the lingual nerve has been proposed as the reason that injury to the nerve at this site involves the entire lingual nerve distribution rather than limited number of peripheral areas. The lingual nerve is often comprised of a single fascicle at the level of the lingula with 7-39 fascicles in the third molar area (Pogrel 2003). Anesthetics are delivered to the pterygomandibular space through wihch the lingual nerve and inferior alveolar nerve travel. Inferior alveolar nerve blocks are common in dentistry. greater success rate wtih LNB due to easier and closer access to target area.The depth of penetration of the needle is 5-8 mmīalasubramanian et al (2017 suggested advantages to the selective lingual nerve block (LNB) that they compared to IANB are.The target area is the lingula nerve in the third molar region.The barrel of the syringe is place dover the contralateral incisor/canine region - angulated toward the second molar. ![]() Point of insertion of needle is distal and 6-8 mm inferior to the lingual gingival margin of the second lower molar.These investigators describe isolated lingual nerve block as: Of the three terminal branches of the inferior alveolar nerve, the inferior alveolar nerve (supplying mandibular teeth) and the buccal nerve (supplying the skin over the buccinator, buccal mucous membrane and buccal gingiva of the molars) do not need anesthesia when the isolated block of the lingual nerve (supplying the lingual gingiva, mucosa of the anterior 2/3 of the tonuge, and floor of mouth) will suffice. Balasubramanian et al (2017) suggested that the commonly used inferior alveolar nerve block (IANB) unnecessarily blocks all three branches of the inferior alveolar nerve when selective anesthesia of the tongue, floor of mouth and lingual mucoperiosteum is needed. ![]()
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