IAN Block

[mikenorm556]

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3rd year dental student here. Can some docs please post their techniques for an IAN block.

I can never see the fu***** pterygomandibular raphe clinically- even when pulling the tissue taut.

Thanks.

 

[toothdriller2k17]

 

[toothdriller2k17]

curious though, when did you start seeing patients?

 

[mikenorm556]

Dude, I have watched this so many times.
Regarding that video though, clinically do you think the injection site would be higher the majority of the time?

 

[mikenorm556]

curious though, when did you start seeing patients?

Pretty much in my 3rd year. Where I am now. But by luck and pt needs I have not done many cases where I need to perform a block.

 

[toothdriller2k17]

@mikenorm556

you feel for the coronoid notch with your index finger , then you ask the patient to open up real wide, come in from the contralateral PM and bisect your finger nail...hit bone, aspirate, move the needle out and then angle it so that you're coming in from the incisors..aspirate, then ideally go in 3/4 of the needle.

i mean it should be slightly higher but every patient is different. when the tissue is taut try to visualize the raphe and that triangle area of space. you should not feel resistance when you advance the needle..if you do you're doing it wrong. check the image below

it's by trial and error to be honest...if anything ask a faculty to show you, that's why they are there.

http://pocketdentistry.com/wp-content/uploads/285/F000145f014-003-97803230741311.jpg

 

[vellnueve]

Dude, I have watched this so many times.
Regarding that video though, clinically do you think the injection site would be higher the majority of the time?

If you're going to miss, miss high.

 

[baby.smiles]

This is the video I use and has worked majority of the time!
I know it is isn't anatomically appropriate but when I have a hard time seeing the raphe or getting a good grasp on the process, this trick helps me

 

[OhioDMD]

Akinosi ....... 25 gauge long, 3% Carbocaine
I haven't missed a block in over 2 years since I switched to this technique.

 

[ktran17]

Akinosi ....... 25 gauge long, 3% Carbocaine
I haven't missed a block in over 2 years since I switched to this technique.

Do you bend the needle as demonstrated by the video?

 

[OhioDMD]

I give it about a 15 degree bend as demonstrated in the video.

 

[psiyung]

come in at a steep angle when u enter raphe and hit ramus...then follow ramus back and inject...98% effective

 

[aspiringdds02]

Always aim high. Also a 3rd year. When I first started I was aiming too low and subsequently missing blocks. An OS faculty mentioned that when you aim high, even if you miss, gravity will pull it down and anesthetize the nerve anyway. My success rates have been very very high since the adjustment.