DOCSLIB.ORG

Final Oral Surgery and Pain Control Layout 1

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
Final Oral Surgery and Pain Control Layout 1 Mylohyoid nerve Just before entering the mandibular canal the inferior alveolar nerve gives off a motor branch known as the mylohyoid nerve. The inferior alveolar nerve travels along with the inferior alveolar artery and vein within the mandibular canal and divides into the mental and incisive nerve branches at the mental foramen. The inferior alveolar nerve provides sensation to the mandibular posterior teeth. The mylohyoid nerve pierces the spheno- mandibular ligament and runs inferiorly and anteriorly in the mylohyoid groove and then onto the inferior surface of the mylohyoid muscle. The mylohyoid nerve serves as an ef- ferent nerve to the mylohyoid muscle and the anterior belly of the digastric muscle. This nerve may in some cases also serve as an afferent nerve for the mandibular first molar. The mylohyoid muscle is an anterior suprahyoid muscle that is deep to the digastric mus- cle. In addition to either elevating the hyoid bone or depressing the mandible, the muscle also forms the floor of the mouth and helps elevate the tongue. Note: The sublingual gland is located superior to the mylohyoid muscle. 1. When placing the film for a periapical view of the mandibular molars, it is Notes the mylohyoid muscle that gets in the way if it is not relaxed. 2. When the floor of the mouth is lowered surgically, the mylohyoid and ge- nioglossus muscles are detached. 3. An injection into the parotid gland (capsule) when attempting to administer an inferior nerve block may cause a Bell's palsy facial expression ⎯ paralysis of the forehead muscles, the eyelid and of the upper and lower lips on the same side of the face that the injection was given. Important: If the parotid capsule injection happens, care must be taken to protect the eye from injury and drying using lubrication and an eye patch. 4. Remember: The bone of the maxilla is more porous than that of the mandible, therefore, it can be infiltrated anywhere. .
Load more

Recommended publications
  • Neck Dissection Using the Fascial Planes Technique
    OPEN ACCESS ATLAS OF OTOLARYNGOLOGY, HEAD & NECK OPERATIVE SURGERY NECK DISSECTION USING THE FASCIAL PLANE TECHNIQUE Patrick J Bradley & Javier Gavilán The importance of identifying the presence larised in the English world in the mid-20th of metastatic neck disease with head and century by Etore Bocca, an Italian otola- neck cancer is recognised as a prominent ryngologist, and his colleagues 5. factor determining patients’ prognosis. The current available techniques to identify Fascial compartments allow the removal disease in the neck all have limitations in of cervical lymphatic tissue by separating terms of accuracy; thus, elective neck dis- and removing the fascial walls of these section is the usual choice for management “containers” along with their contents of the clinically N0 neck (cN0) when the from the underlying vascular, glandular, risk of harbouring occult regional metasta- neural, and muscular structures. sis is significant (≥20%) 1. Methods availa- ble to identify the N+ (cN+) neck include Anatomical basis imaging (CT, MRI, PET), ultrasound- guided fine needle aspiration cytology The basic understanding of fascial planes (USGFNAC), and sentinel node biopsy, in the neck is that there are two distinct and are used depending on resource fascial layers, the superficial cervical fas- availability, for the patient as well as the cia, and the deep cervical fascia (Figures local health service. In many countries, 1A-C). certainly in Africa and Asia, these facilities are not available or affordable. In such Superficial cervical fascia circumstances patients with head and neck cancer whose primary disease is being The superficial cervical fascia is a connec- treated surgically should also have the tive tissue layer lying just below the der- neck treated surgically.
    [Show full text]
  • Numb Tongue, Numb Lip, Numb Chin: What to Do When?
    NUMB TONGUE, NUMB LIP, NUMB CHIN: WHAT TO DO WHEN? Ramzey Tursun, DDS, FACS Marshall Green, DDS Andre Ledoux, DMD Arshad Kaleem, DMD, MD Assistant Professor, Associate Fellowship Director of Oral, Head & Neck Oncologic and Microvascular Reconstructive Surgery, DeWitt Daughtry Family Department of Surgery, Division of Oral Maxillofacial Surgery, Leonard M. Miller School of Medicine, University of Miami INTRODUCTION MECHANISM OF NERVE Microneurosurgery of the trigeminal nerve INJURIES has been in the spotlight over the last few years. The introduction of cone-beam When attempting to classify the various scanning, three-dimensional imaging, mechanisms of nerve injury in the magnetic resonance neurography, maxillofacial region, it becomes clear that endoscopic-assisted surgery, and use of the overwhelming majority are iatrogenic allogenic nerve grafts have improved the in nature. The nerves that are most often techniques that can be used for affected in dento-alveolar procedures are assessment and treatment of patients with the branches of the mandibular division of nerve injuries. Injury to the terminal cranial nerve V, i.e., the trigeminal nerve. branches of the trigeminal nerve is a well- The lingual nerve and inferior alveolar known risk associated with a wide range of nerve are most often affected, and third dental and surgical procedures. These molar surgery is the most common cause 1 injuries often heal spontaneously without of injury. medical or surgical intervention. However, they sometimes can cause a variety of None of these nerves provide motor symptoms, including lost or altered innervation. However, damage to these sensation, pain, or a combination of these, nerves can cause a significant loss of and may have an impact on speech, sensation and/or taste in affected patients.
    [Show full text]
  • The Influence of Mandibular Skeletal Characteristics on Inferior Alveolar Nerve Block Anesthesia
    pISSN 2383-9309❚eISSN 2383-9317 Original Article J Dent Anesth Pain Med 2015;15(3):113-119❚http://dx.doi.org/10.17245/jdapm.2015.15.3.113 The influence of mandibular skeletal characteristics on inferior alveolar nerve block anesthesia Tae Min You1, Kee-Deog Kim2, Jisun Huh2, Eun-Jung Woo2, Wonse Park2 1Department of Advanced General Dentistry, College of Dentistry, Dankook University, Cheonan, Korea 2Department of Advanced General Dentistry, College of Dentistry, Yonsei University, Seoul, Korea Background: The inferior alveolar nerve block (IANB) is the most common anesthetic techniques in dentistry; however, its success rate is low. The purpose of this study was to determine the correlation between IANB failure and mandibular skeletal characteristics Methods: In total, 693 cases of lower third molar extraction (n = 575 patients) were examined in this study. The ratio of the condylar and coronoid distances from the mandibular foramen (condyle-coronoid ratio [CC ratio]) was calculated, and the mandibular skeleton was then classified as normal, retrognathic, or prognathic. The correlation between IANB failure and sex, treatment side, and the CC ratio was assessed. Results: The IANB failure rates for normal, retrognathic, and prognathic mandibles were 7.3%, 14.5%, and 9.5%, respectively, and the failure rate was highest among those with a CC ratio < 0.8 (severe retrognathic mandible). The failure rate was significantly higher in the retrognathic group than in normal group (P = 0.019), and there was no statistically significant difference between the other two groups. Conclusions: IANB failure could be attributable, in part, to the skeletal characteristics of the mandible.
    [Show full text]
  • Anatomy of Maxillary and Mandibular Local Anesthesia
    Anatomy of Mandibular and Maxillary Local Anesthesia Patricia L. Blanton, Ph.D., D.D.S. Professor Emeritus, Department of Anatomy, Baylor College of Dentistry – TAMUS and Private Practice in Periodontics Dallas, Texas Anatomy of Mandibular and Maxillary Local Anesthesia I. Introduction A. The anatomical basis of local anesthesia 1. Infiltration anesthesia 2. Block or trunk anesthesia II. Review of the Trigeminal Nerve (Cranial n. V) – the major sensory nerve of the head A. Ophthalmic Division 1. Course a. Superior orbital fissure – root of orbit – supraorbital foramen 2. Branches – sensory B. Maxillary Division 1. Course a. Foramen rotundum – pterygopalatine fossa – inferior orbital fissure – floor of orbit – infraorbital 2. Branches - sensory a. Zygomatic nerve b. Pterygopalatine nerves [nasal (nasopalatine), orbital, palatal (greater and lesser palatine), pharyngeal] c. Posterior superior alveolar nerves d. Infraorbital nerve (middle superior alveolar nerve, anterior superior nerve) C. Mandibular Division 1. Course a. Foramen ovale – infratemporal fossa – mandibular foramen, Canal -> mental foramen 2. Branches a. Sensory (1) Long buccal nerve (2) Lingual nerve (3) Inferior alveolar nerve -> mental nerve (4) Auriculotemporal nerve b. Motor (1) Pterygoid nerves (2) Temporal nerves (3) Masseteric nerves (4) Nerve to tensor tympani (5) Nerve to tensor veli palatine (6) Nerve to mylohyoid (7) Nerve to anterior belly of digastric c. Both motor and sensory (1) Mylohyoid nerve III. Usual Routes of innervation A. Maxilla 1. Teeth a. Molars – Posterior superior alveolar nerve b. Premolars – Middle superior alveolar nerve c. Incisors and cuspids – Anterior superior alveolar nerve 2. Gingiva a. Facial/buccal – Superior alveolar nerves b. Palatal – Anterior – Nasopalatine nerve; Posterior – Greater palatine nerves B.
    [Show full text]
  • Communication Between the Mylohyoid and Lingual Nerves: Clinical Implications
    Int. J. Morphol., Case Report 25(3):561-564, 2007. Communication Between the Mylohyoid and Lingual Nerves: Clinical Implications Comunicación entre los Nervios Milohioideo y Lingual: Implicancias Clínicas *Valéria Paula Sassoli Fazan; **Omar Andrade Rodrigues Filho & ***Fernando Matamala FAZAN, V. P. S.; RODRIGUES FILHO, O. A. & MATAMALA, F. Communication between the mylohyoid and lingual nerves: Clinical implications. Int. J. Morphol., 25(3):561-564, 2007. SUMMARY: The mylohyoid muscle plays an important role in chewing, swallowing, respiration and phonation, being the mylohyoid nerve also closely related to these important functions. It has been postulated that the mylohyoid nerve might have a role in the sensory innervation of the chin and the lower incisor teeth while the role of the mylohyoid nerve in the mandibular posterior tooth sensation is still a controversial issue. Although variations in the course of the mylohyoid nerve in relation to the mandible are frequently found on the dissecting room, they have not been satisfactorily described in the anatomical or surgical literature. It is well known that variations on the branching pattern of the mandibular nerve frequently account for the failure to obtain adequate local anesthesia in routine oral and dental procedures and also for the unexpected injury to branches of the nerves during surgery. Also, anatomical variations might be responsible for unexpected and unexplained symptoms after a certain surgical procedure. We describe the presence of a communicating branch between the mylohyoid and lingual nerves in an adult male cadaver, and discuss its clinical/surgical implications as well as its possible role on the sensory innervation of the tongue.
    [Show full text]
  • Inferior Alveolar Nerve Trajectory, Mental Foramen Location and Incidence of Mental Nerve Anterior Loop
    Med Oral Patol Oral Cir Bucal. 2017 Sep 1;22 (5):e630-5. CBCT anatomy of the inferior alveolar nerve Journal section: Oral Surgery doi:10.4317/medoral.21905 Publication Types: Research http://dx.doi.org/doi:10.4317/medoral.21905 Inferior alveolar nerve trajectory, mental foramen location and incidence of mental nerve anterior loop Miguel Velasco-Torres 1, Miguel Padial-Molina 1, Gustavo Avila-Ortiz 2, Raúl García-Delgado 3, Andrés Ca- tena 4, Pablo Galindo-Moreno 1 1 DDS, PhD, Department of Oral Surgery and Implant Dentistry, School of Dentistry, University of Granada, Granada, Spain 2 DDS, MS, PhD, Department of Periodontics, College of Dentistry, University of Iowa, Iowa City, USA 3 Specialist in Dental and Maxillofacial Radiology. Private Practice. Granada, Spain 4 PhD, Department of Experimental Psychology, School of Psychology, University of Granada, Granada, Spain Correspondence: School of Dentistry, University of Granada 18071 - Granada, Spain [email protected] Velasco-Torres M, Padial-Molina M, Avila-Ortiz G, García-Delgado R, Catena A, Galindo-Moreno P. Inferior alveolar nerve trajectory, mental foramen location and incidence of mental nerve anterior loop. Med Oral Received: 07/03/2017 Accepted: 21/06/2017 Patol Oral Cir Bucal. 2017 Sep 1;22 (5):e630-5. http://www.medicinaoral.com/medoralfree01/v22i5/medoralv22i5p630.pdf Article Number: 21905 http://www.medicinaoral.com/ © Medicina Oral S. L. C.I.F. B 96689336 - pISSN 1698-4447 - eISSN: 1698-6946 eMail: [email protected] Indexed in: Science Citation Index Expanded Journal Citation Reports Index Medicus, MEDLINE, PubMed Scopus, Embase and Emcare Indice Médico Español Abstract Background: Injury of the inferior alveolar nerve (IAN) is a serious intraoperative complication that may occur during routine surgical procedures, such as dental implant placement or extraction of impacted teeth.
    [Show full text]
  • An Anomalous Digastric Muscle in the Carotid Sheath: a Case Report with Its
    Short Communication 2020 iMedPub Journals Journal of Stem Cell Biology and Transplantation http://journals.imedpub.com Vol. 4 ISS. 4 : sc 37 ISSN : 2575-7725 DOI : 10.21767/2575-7725.4.4.37 8th Edition of International Conference on Clinical and Medical Case Reports - An anomalous digastric muscle in the carotid sheath: a case report with its embryological perspective and clinical relevance Srinivasa Rao Sirasanagandla Sultan Qaboos University, Oman Abstract Key words: Although infrahyoid muscles show considerable variations in Anterior belly, Posterior belly, Variation, Stylohyoid muscle, My- their development, existence of an anomalous digastric muscle lohyoid muscle, Hyoid bone in the neck was seldom reported. During dissection of trian- Anatomy gles of the neck for medical undergraduate students, we came across an anomalous digastric muscle in the carotid sheath of There is a pair of digastric muscles in the neck, and each digas- left side of neck. It was observed in a middle-aged cadaver at tric muscle has the anterior belly and the posterior belly. The College of Medicine and Health Sciences, Sultan Qaboos Uni- anterior belly is attached to the digastric fossa on the base of versity, Muscat, Oman. Digastric muscle was located within the the mandible close to the midline and runs toward the hyoid carotid sheath between the common and internal carotid arter- bone. The posterior belly is attached to the notch of the mas- ies and internal jugular vein. It had two bellies; cranial belly and toid process of the temporal bone and also runs toward the caudal belly which were connected by an intermediate tendon.
    [Show full text]
  • The Digastric Muscle's Anterior Accessory Belly: Case Report
    Med Oral Patol Oral Cir Bucal 2007;12:E341-3. The digastric muscle’s anterior accessory belly Med Oral Patol Oral Cir Bucal 2007;12:E341-3. The digastric muscle’s anterior accessory belly The digastric muscle’s anterior accessory belly: Case report Genny Reyes 1, Camilo Contreras 2, Luis Miguel Ramírez 3, Luis Ernesto Ballesteros 4 (1) Medicine Student. First Semester. Universidad Industrial de Santander (UIS), Bucaramanga (2) Medicine Student. Third Semester. Universidad Industrial de Santander (UIS), Bucaramanga (3) Doctor of Prosthetic Dentistry and Temporomandibular Disorders from Universidad Javeriana, Santa fe de Bogota, Colombia. Associate Professor of Morphology, Department of Basic Sciences at the Universidad Industrial de Santander (UIS), Bucaramanga (4) Medical Doctor. Degree in Basic Sciences, Universidad del Valle, Cali, Colombia. Director of the Basic Sciences Department at Universidad Industrial de Santander (UIS), Bucaramanga, Colombia Correspondence: Dr. Luis Miguel Ramirez Aristeguieta E-mail: [email protected] Reyes G, Contreras C, Ramirez LM, Ballesteros LE. The digastric Received: 23-05-2006 muscle’s anterior accessory belly: Case report. Med Oral Patol Oral Cir Accepted: 10-04-2007 Bucal 2007;12:E341-3. © Medicina Oral S. L. C.I.F. B 96689336 - ISSN 1698-6946 Indexed in: -Index Medicus / MEDLINE / PubMed -EMBASE, Excerpta Medica -SCOPUS -Indice Médico Español -IBECS ABStract Digastric muscle is characterized by presenting occasional variations. The suprahyoid region of an 83 year-old male cadaver was dissected and an anatomic variation of the digastric muscle was observed in its anterior belly. It consisted of an accessory bilateral anterior belly originating in the intermediate tendon and inserted into the mylohyoid raphe.
    [Show full text]
  • Anatomy of Mandibular Vital Structures. Part I: Mandibular Canal and Inferior Alveolar Neurovascular Bundle in Relation with Dental Implantology
    JOURNAL OF ORAL & MAXILLOFACIAL RESEARCH Juodzbalys et al. Anatomy of Mandibular Vital Structures. Part I: Mandibular Canal and Inferior Alveolar Neurovascular Bundle in Relation with Dental Implantology Gintaras Juodzbalys1, Hom-Lay Wang2, Gintautas Sabalys1 1Department of Oral and Maxillofacial Surgery, Kaunas University of Medicine, Lithuania 2Department of Periodontics and Oral Medicine, University of Michigan, Ann Arbor Michigan, USA Corresponding Author: Gintaras Juodzbalys Vainiku 12 LT- 46383, Kaunas Lithuania Phone: +370 37 29 70 55 Fax: +370 37 32 31 53 E-mail: [email protected] ABSTRACT Objectives: It is critical to determine the location and configuration of the mandibular canal and related vital structures during the implant treatment. The purpose of the present paper was to review the literature concerning the mandibular canal and inferior alveolar neurovascular bundle anatomical variations related to the implant surgery. Material and Methods: Literature was selected through the search of PubMed, Embase and Cochrane electronic databases. The keywords used for search were mandibular canal, inferior alveolar nerve, and inferior alveolar neurovascular bundle. The search was restricted to English language articles, published from 1973 to November 2009. Additionally, a manual search in the major anatomy, dental implant, prosthetic and periodontal journals and books were performed. Results: In total, 46 literature sources were obtained and morphological aspects and variations of the anatomy related to implant treatment in posterior mandible were presented as two entities: intraosseous mandibular canal and associated inferior alveolar neurovascular bundle. Conclusions: A review of morphological aspects and variations of the anatomy related to mandibular canal and mandibular vital structures are very important especially in implant therapy since inferior alveolar neurovascular bundle exists in different locations and possesses many variations.
    [Show full text]
  • Atlas of the Facial Nerve and Related Structures
    Rhoton Yoshioka Atlas of the Facial Nerve Unique Atlas Opens Window and Related Structures Into Facial Nerve Anatomy… Atlas of the Facial Nerve and Related Structures and Related Nerve Facial of the Atlas “His meticulous methods of anatomical dissection and microsurgical techniques helped transform the primitive specialty of neurosurgery into the magnificent surgical discipline that it is today.”— Nobutaka Yoshioka American Association of Neurological Surgeons. Albert L. Rhoton, Jr. Nobutaka Yoshioka, MD, PhD and Albert L. Rhoton, Jr., MD have created an anatomical atlas of astounding precision. An unparalleled teaching tool, this atlas opens a unique window into the anatomical intricacies of complex facial nerves and related structures. An internationally renowned author, educator, brain anatomist, and neurosurgeon, Dr. Rhoton is regarded by colleagues as one of the fathers of modern microscopic neurosurgery. Dr. Yoshioka, an esteemed craniofacial reconstructive surgeon in Japan, mastered this precise dissection technique while undertaking a fellowship at Dr. Rhoton’s microanatomy lab, writing in the preface that within such precision images lies potential for surgical innovation. Special Features • Exquisite color photographs, prepared from carefully dissected latex injected cadavers, reveal anatomy layer by layer with remarkable detail and clarity • An added highlight, 3-D versions of these extraordinary images, are available online in the Thieme MediaCenter • Major sections include intracranial region and skull, upper facial and midfacial region, and lower facial and posterolateral neck region Organized by region, each layered dissection elucidates specific nerves and structures with pinpoint accuracy, providing the clinician with in-depth anatomical insights. Precise clinical explanations accompany each photograph. In tandem, the images and text provide an excellent foundation for understanding the nerves and structures impacted by neurosurgical-related pathologies as well as other conditions and injuries.
    [Show full text]
  • Physiologic Factors for Dental Anesthesia Injections
    ARE YOU NUMB YET? THE ANATOMY OF LOCAL ANESTHESIA PART 2: TECHNIQUES PHYSIOLOGIC FACTORS FOR DENTAL ANESTHESIA Alan W. Budenz, MS, DDS, MBA INJECTIONS Dept. of Biomedical Sciences and Vice Chair of Diagnostic Sciences & Services, Dept. of Dental Practice University of the Pacific, Arthur A. Dugoni School of Dentistry San Francisco, California Success versus Failure [email protected] Failed Anesthetic: Measuring the Problem Physiology of Anesthetic Agents One of every three patients is not properly numb when the dentist or hygienist is ready to start (or actually starts) a dental procedure. How do we assess anesthesia? Is this “failed anesthetic”? 60% Question the patient Soft tissue only 50% * Probe the area 46% Average 40% 42% 41% Failure 38% Rate is Cold test 30% 29% Pulpal tissue 31% Electric pulp tester 20% 19% 20% 17% 15% How is anesthetic success defined in studies? 10% Frequency Frequency Anesthetic Failedof Ideal: 2 consecutive 80/80 readings with EPT within 15 0% IAN Blocks - 15 min. after injection Maxillary infiltrations - 10 min. after injection minutes of injection (and sustained for 60 mins) Delayed pulpal onset: occurs in the mandible of 19 – 27% Slide courtesy Dr. Mic Falkel of patients (even though soft tissue is numb) Delayed over 30 minutes in 8% Nusstein J et al. The challenges of successful * Average failure rate reported across 38 published studies mandibular anesthesia, Inside Dentistry, May 2008 Physiology of Anesthetic Agents Blocks versus Infiltrations Onset of anesthesia: Advantages of infiltrations 1. Dependent upon anesthetic agent 1. Faster onset Concentration 2. Diffusion to the site Simple Lipid solubility 3.
    [Show full text]
  • Anatomy Respect in Implant Dentistry. Assortment, Location, Clinical Importance (Review Article)
    ISSN: 2394-8418 DOI: https://doi.org/10.17352/jdps CLINICAL GROUP Received: 19 August, 2020 Review Article Accepted: 31 August, 2020 Published: 01 September, 2020 *Corresponding author: Dr. Rawaa Y Al-Rawee, BDS, Anatomy Respect in Implant M Sc OS, MOMS MFDS RCPS Glasgow, PhD, MaxFacs, Department of Oral and Maxillofacial Surgery, Al-Salam Dentistry. Assortment, Teaching Hospital, Mosul, Iraq, Tel: 009647726438648; E-mail: Location, Clinical Importance ORCID: https://orcid.org/0000-0003-2554-1121 Keywords: Anatomical structures; Dental implants; (Review Article) Basic implant protocol; Success criteria; Clinical anatomy Rawaa Y Al-Rawee1* and Mohammed Mikdad Abdalfattah2 https://www.peertechz.com 1Department of Oral and Maxillofacial Surgery, Al-Salam Teaching Hospital. Mosul, Iraq 2Post Graduate Student in School of Dentistry, University of Leeds. United Kingdom, Ministry of Health, Iraq Abstract Aims: In this article; we will reviews critically important basic structures routinely encountered in implant therapy. It can be a brief anatomical reference for beginners in the fi eld of dental implant surgeries. Highlighting the clinical importance of each anatomical structure can be benefi cial for fast informations refreshing. Also it can be used as clinical anatomical guide for implantologist and professionals in advanced surgical procedures. Background: Basic anatomy understanding prior to implant therapy; it's an important fi rst step in dental implant surgery protocol specifi cally with technology advances and the popularity of dental implantation as a primary choice for replacement loosed teeth. A thorough perception of anatomy provides the implant surgeon with the confi dence to deal with hard or soft tissues in efforts to restore the exact aim of implantation whether function or esthetics and end with improving health and quality of life.
    [Show full text]