Technique of carrying out mental (colonic) anesthesia: intraoral and extraoral methods

Mental anesthesia (chin anesthesia) is nerve conduction (freezing) of nerves from the inside or outside to the chin foramen.

According to the anatomical structure, the lower jaw has almost no holes and consists of very dense layers, therefore, if problems arise with the lower jaw, mental anesthesia is performed.

Indications for use

Indications for the use of this type of anesthesia:

• injury, broken jaw;
• in the case when other types of anesthesia are ineffective or it is not possible to carry out a general blockage of the nerves;
• at prosthetics, implantation teeth;
• during treatment caries neglected or with complications;
• in the treatment of soft tissues of the oral cavity, periodontium;
• in the case of opening the focus of inflammation, which is accompanied by a strong release of fluids (pus);
• when collecting cells, tissues of the jaw for their study;
• with difficult tooth extraction on the lower jaw;
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• surgical operations to remove, align the teeth of the lower jaw, remove a benign - malignant tumor.

In surgical intervention, metal anesthesia is not used alone, but only as an adjunct to basic anesthesia.

Peculiarities

The peculiarity of anesthesia is the low probability of ineffective effects on the nerves of the mandible. And also the definition of the hole in the chin (the mouth of the canal) using an X-ray or palpation. The hole can be on the patient's right or left side, or on both sides at once, depending on the patient's anatomical features.

How to find the target point

In humans, the mouth of the canal has the shape of an oval or circle, is located under 2 premolar or between 2 and 1 premolars. For different ages of patients, the target point, the chin foramen, can be displaced. For children with milk teeth, more often the hole is displaced to the outside and is located under the milk first premolar.

For elderly patients, such anesthesia is performed during age-related tooth loss or damage, with atrophic processes in the tissues of the oral cavity. The hole is located in the lower jaw near the alveolar margin.

It is important to correctly determine the position of the canal orifice in order to insert the needle with the anesthetic drug in the right direction. The chin hole can be positioned: upward, backward, or outward.

Technique

There are 2 options for conducting mental anesthesia: intraoral and extraoral intracanal. To perform the freezing procedure, a 2 ml disposable syringe with a needle length of 2.5 cm is required.

Intraoral method

1. The patient completely closes the jaw teeth or opens a little. The dentist pushes the soft tissues of the right cheek (left) and lip away from the lower jaw as much as possible.
2. Trially injects 0.5 ml of the drug with a syringe, inserting the needle slightly above the transitional fold of the 1st premolar at the level of the middle of the crown, advancing it to the chin foramen.
3. Next, the dentist finds the mouth of the canal. He will feel that the needle has sunk inward.
4. The action of the drug occurs when the patient feels tingling or pain in the lower jaw, lip.
5. After that, the rest of the drug is injected to a channel depth of 3 mm.

This method provides pain relief in 4-6 minutes, which lasts for 1.5-5 hours. There is a freezing of the tissues of the anterior teeth, canine, alveolar ridge, 1-2 premolars, tissues of the lip, chin.

Extraoral intracanal method

1. The dentist fixes the patient's chin and the puncture site with his left hand.
2. With the right hand, pierces with a needle 0.5 mm higher along the chin canal.
3. First, 0.5 ml of anesthetic drug is injected. The needle is pushed deeper (down) and forward so that it touches the bone.
4. Next, a 3-4 mm hole is entered into the channel and the drug is injected.

The drug begins to act in the same way as with the intraoral method.

Possible complications

If the target is hit incorrectly or inaccurately, a hematoma may form. Due to getting into the chin nerve, neuritis develops. Blockage of blood vessels (ischemia) of the tissues of the lip or chin may also occur.