Ovidental Editorial Team
hola@ovidentalgo.com
The infraorbital nerve block is a pivotal technique in dentistry, facilitating effective anesthesia of the midfacial region.
By targeting the infraorbital nerve—a branch of the maxillary nerve (CN V2)—this procedure ensures analgesia for areas such as the lower eyelid, upper cheek, side of the nose, and upper lip.
Its precise application is essential for various dental and surgical interventions, minimizing patient discomfort and enhancing procedural outcomes.
Anatomical Overview
The infraorbital nerve originates from the maxillary nerve and traverses the infraorbital groove and canal, emerging onto the face through the infraorbital foramen.
This foramen is typically located approximately 1 cm below the infraorbital rim, aligning vertically with the pupil when the patient maintains a forward gaze.
Upon exiting, the nerve bifurcates into several branches, providing sensory innervation to the aforementioned facial regions.
Clinical Significance in Dentistry
Implementing the infraorbital nerve block is crucial for dental procedures involving the maxillary anterior teeth, including extractions, restorations, and periodontal surgeries.
This technique offers profound anesthesia without causing tissue distortion, thereby preserving anatomical landmarks and facilitating precise surgical interventions.
Additionally, it serves as an effective analgesic approach for managing midfacial trauma and postoperative pain, reducing the reliance on systemic narcotics and their associated side effects.
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Techniques for Infraorbital Nerve Block
Two primary approaches are employed to administer the infraorbital nerve block:
1. Intraoral Approach
* The patient is positioned with the maxillary occlusal plane at a 45-degree angle to the floor.
* After applying a topical anesthetic, a needle is inserted into the mucobuccal fold above the maxillary second premolar.
* The needle is advanced parallel to the long axis of the tooth toward the infraorbital foramen.
* Aspiration is performed to avoid intravascular injection before administering the anesthetic solution.
2. Extraoral Approach
* The infraorbital foramen is palpated externally, located directly below the infraorbital ridge and in line with the pupil.
* After aseptic preparation, a needle is inserted percutaneously toward the infraorbital foramen.
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Aspiration is conducted to ensure the needle is not within a vessel before injecting the anesthetic.
Considerations and Complications
While generally safe, the infraorbital nerve block may present potential complications, including:
- Hematoma Formation: Due to vascular proximity, inadvertent vessel puncture can lead to hematoma.
- Nerve Injury: Improper needle placement may result in transient or permanent nerve damage.
- Infection: Though rare, breaches in aseptic technique can introduce pathogens.
- Intravascular Injection: Accidental administration into a vessel can cause systemic anesthetic toxicity.
To mitigate these risks, clinicians must possess a thorough understanding of the regional anatomy, adhere to meticulous technique, and perform careful aspiration prior to injection.
Conclusion
The infraorbital nerve block remains an indispensable tool in dental practice, offering targeted anesthesia for midfacial procedures. Its proper execution not only enhances patient comfort but also contributes to the precision and success of dental treatments.
Continuous education and hands-on training are essential for practitioners to maintain proficiency in this technique, ensuring optimal patient outcomes.
References
- J Oral Biol Craniofac Res. 2021. Infra-orbital nerve block using alar base approach: A novel landmark and technique.
- Phil Y. Yao; Miguel B. Sequeira Campos. 2024. Infraorbital Nerve Block.
- Kang-Jae Shin, Shin-Hyo Lee, Min-Gyu Park, Hyun Jin Shin. 2020. Location of the accessory infraorbital foramen with reference to external landmarks and its clinical implications.
