the inferior alveolar nerve block is the most widely used in the industry and yet many people do it wrong this video is very important because you will understand the step-by-step of the technique according to malamad this exact raised of this blockage is 80 to 85 percent but if you not execute it correctly the index drop a lot so pay attention and understand it definitely the first step you should palpate and identify the anterior border of the mandibular ramus the patient must keep the maximum mouth opening your index finger should be around about one centimeter above the occlusal plane the second anatomical structure that you should identify is the pythagorean mandibular wrath taking these structures in account you will draw an imaginary straight line from the center of your fingertip to the deepest part of the pythagorean mandibular wrath the ref starts from the region of the rather mullen trigon and goes towards one extremity to the hamulus of the mediocre plate in this path it deepens in certain place the next step is to divide this imaginary line into four parts the puncture point will be three quarters of the distance from the anterior border of the magiblaramus concerning this imaginary line to the deepest part to the ptargo mandibular wrath a basic mistake is to make the puncture much anterior which causes the needle to touch the bone very early and the anaesthetic solution is deposited in the wrong place keep in mind that the correct positioning of the syringe is with its body at the level of the promoter teeth on the opposite side of the puncture in some case when the mandible is very divergent you can position this ring a little more posteriorly almost on the molar on the opposite side the next step is to insert the needle into the target area until you feel a kind of bone resistance it is important not to force the needle against the bone so you could damage the needle bevel the needle needs to be 25 or 27 gauge long the needle is inserted almost entirely a small segment of the needle usually remains outside of the oral tissues which is desirable because if the patient makes some silly movement in the needle bricks usually the needle breaks at the junction with the hub this way this could be more easily removed if you inserted the entire needle and did not touch the bone you have your puncture point to posterior or the body of the syringe to anterior at the level of the first promoter then you need to modify and reintroduce it after touching the bone you will retract the needle about one millimeter why did you do that to prevent the tip of the needle for bringing sign of the mandibular foramen then you perform the aspiration maneuver to make sure that you are not inside of any blood vessel or artery a rapid intravascular injection can lead to a relative overdoses reactions in addition to anesthesia not to be installed you have to realize that for the nerve impulse to be prevented from being conducted through the nerve fibers the anaesthetic solution must be in contact in direct contact with the nerve which is not the case with an intravascular injection you administer the dystrophic solution slowly and steadily the glass cartridge has advantage over the plastic cartridge more about it later in another video the slow steady injection should take about one minute you don't need to time it just keep in mind that the position needs to be slow will you administer all the content of the cartridge in this location no you leave a small amount something around 0.1 millimeter of an aesthetic solution for the anesthesia of the lingual nerve then you withdraw the needle in half and deposit the rest of the nasal solution the lingual nerve is located anterior to the inferior velar nerve which is why we perform this reposition of the needle at the end of your deposition of the entire content of the cartridge the needle can be completely removed and will wait for the onset how long should you wait at least 5 minutes ideally 10 or even 50 minutes it's here that most dentists make some mistakes they perform the technique and already try to start the procedure right after the first numbness of the lips often the lips are nub but the poop anesthesia is not yet fully established hence the importance of waiting 10 minutes or more this is the inferior of your nerve block technique soon i will post more videos to complement this one if you want to be notified about it just subscribe the channel in the link below also comment below what your main doubts so i can create a new content on the topics you need most okay bye bye