Infra Orbital Nerve Block Technique. Step Wise.

It is a nerve block ( local Anesthesia ) given to anesthetize the anterior and middle superior alveolar nerve to facilitate many Dental Surgery Procedures. It also anesthetize infra orabital nerve and it's branches (inferior palpebral, lateral nasal and superior labial nerves ).

Area to be anesthetized- Upper incisor, canine, premolars and mesiobuccal root of first molar of the side on which block is given

Other areas anesthetized- Lower eye lid, lateral part of nose, and the portion of the lip on the side of block

Land marks to remember- Supraorbital notch, pupils of eye, infraorbital ridge, infraorbital notch, inferior orbital depression, maxillary incisors and premolars and mental foramen.


Technique:------------------
Premolar approach
Maxillary premolar approach-
1.Patient is asked to look straight.
2.Infraorbital ridge is palpated to locate infraorbital notch.
3.Now move 0.5 cm down to locate infraorbtial depression which correspond to infraorbital foramen.
4.Insert the needle parallel to imaginary line passing through supraorbital notch, pupil, infraorbital foramen, second premolar and mental foramen.
5.Insert neddle into mucobuccal fold for aprox 5mm.
6.Guide the needle into infraorbital foramen by placing the thumb over infraorbital depression.
7.Inject .8 - 2 ml of solution slowly (after aspirating in two planes)

Central incisor Approach
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Step 1-3 are same
4.Insert the needle from the line of mesio incisal angle of the centaral incisor toward the infra orbital foramen. insert the needle into mucobuccal fold.
Step 7 and 8 are same

Subjective symptoms
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Tingling and numbness of the upper lip and side of the nose and lower eye lid of same side will demonstrate the action of anesthesia but remember these signs are not landmark for good anesthesia because some time these nerves get anesthetize but inraorbital nerve is still not blocked, It's better to tap the tooth of same side and see for any change in sensation with other side.

Objective symptoms
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Absence of pain on instrumentation will demonstrate the objective symptoms.
Use 25 gauge needle for this block.