Applied anatomy of the pterygomandibular space: improving the success of inferior alveolar nerve blocks

Aust Dent J. 2011 Jun;56(2):112-21. doi: 10.1111/j.1834-7819.2011.01312.x.

Abstract

A thorough knowledge of the anatomy of the pterygomandibular space is essential for the successful administration of the inferior alveolar nerve block. In addition to the inferior alveolar and lingual nerves, other structures in this space are of particular significance for local anaesthesia, including the inferior alveolar vessels, the sphenomandibular ligament and the interpterygoid fascia. These structures can all potentially have an impact on the effectiveness of local anaesthesia in this area. Greater understanding of the nature and extent of variation in intraoral landmarks and underlying structures should lead to improved success rates, and provide safer and more effective anaesthesia. The direct technique for the inferior alveolar nerve block is used frequently by most clinicians in Australia and this review evaluates its anatomical rationale and provides possible explanations for anaesthetic failures.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Alveolar Process / blood supply
  • Alveolar Process / innervation
  • Anesthesia, Dental / methods*
  • Arteries / anatomy & histology
  • Fascia / anatomy & histology
  • Humans
  • Ligaments / anatomy & histology
  • Lingual Nerve / anatomy & histology
  • Mandible / anatomy & histology*
  • Mandible / blood supply
  • Mandible / innervation
  • Mandibular Nerve / anatomy & histology*
  • Nerve Block / methods*
  • Pterygoid Muscles / anatomy & histology
  • Safety
  • Sphenoid Bone / anatomy & histology*
  • Sphenoid Bone / innervation
  • Veins / anatomy & histology