Incisive Nerve Research Articles

Anterior loop of the mental canal: an anatomical-radiologic study.

This study sought to characterize the anatomical dimensions of the anterior mental loop and to determine the accuracy of conventional radiographs in identifying its presence and dimensions. The study group consisted of 46 hemimandibles fixed in formalin. Radiographs of the area between the mental foramen and the midline were obtained and evaluated for each hemimandible, followed by dissection and physical examination of the same area. Anatomically, an anterior loop of the mental nerve was observed in only 13 hemimandibles (28%). The anterior extension of the loop ranged from 0.4 to 2.19 mm. No correlation was found between the radiographic image and the anatomical shape of the loop. Of the radiographically diagnosed loops, 40% were not seen in anatomical examination. In cases with a false radiologic loop, a correlation was found between the diameter of the origin of the incisive canal and the radiologic interpretation of the loop. The radiologic appearance or diagnosis of the anterior mental loop in cadaver mandibles does not disclose the true ramification of the inferior alveolar nerve to the mental and incisive nerve.

Atypical incisive nerve: clinical report

Atypical incisive nerve: clinical report

Evaluation of the effectiveness and comfort of incisive nerve anesthesia given inside or outside the mental foramen

Thirty volunteer subjects were given bilateral injections of one-half carpule of 2% Xylocaine with 1:100,000 epinephrine to anesthetize the incisive nerve. Injections were given either inside or outside the mental foramen. Success (80/80 reading) and duration of anesthesia were verified with the Analytic Technology pulp tester. Pain and preference for either injection type were evaluated via questionnaire. The mental foramen could be located in 1 min 56.6% of the time. There was a significantly greater chance of success for injections given inside the foramen for the second bicuspid (p = 0.0422) and the canine (p = 0.015). There was no statistically significant difference in success for either type injection for the first bicuspid (p = 0.184). There was no significant difference in duration of anesthesia whether given inside or outside the foramen and no difference in pain of injection with either type. Patients had no clear-cut preference for either injection type.

An evaluation of the incisive nerve block and combination inferior alveolar and incisive nerve blocks in mandibular anesthesia

The purpose of this study was to measure the degree of anesthesia obtained with the incisive nerve block, the inferior alveolar nerve block and a combination of both injections in mandibular teeth. Using a repeated measures design, 40 subjects randomly received an incisive nerve block, a conventional inferior alveolar nerve block, or a combination inferior alveolar nerve block plus an incisive nerve block using either lidocaine or saline (control), at four successive appointments. The mandibular teeth and contralateral canine (+/- controls) were blindly tested with an Analytic Technology pulp tester at 4-min cycles for 60 min. An 80 reading indicated complete pulpal anesthesia. The incisive nerve block alone did not result in successful pulpal anesthesia in the central, lateral, first, and second molars. It was successful in the first and second premolars but the duration was approximately 30 min. The combination inferior alveolar nerve block plus incisive nerve block was successful in the first and second premolars, and enhanced anesthesia for the laterals and first molars.

Central neurilemmoma of the jaws: Review of literature and case report

Neurilemmomas presenting as primary central bone tumors are extremely rare. Only 21 cases have been reported to have arisen in the jaws; all except for one have occurred in the mandible. The majority of these have been associated with the inferior dental nerve. A case of a central neurilemmoma arising in the anterior mandible is reported. Its probable origin is from one of the alveolar branches of the incisive nerve - an unusual site in the mandible. The radiographic features include expansion of cortical bone, resorption of roots of teeth, the presence of lace-like bony septa and a spotty calcification within the tumor. The treatment and the prognosis are briefly discussed.

Some anatomical and physiological causes of failure to achieve mandibular analgesia

As the sensory nerves within the mandibular structures form a plexus, pain may be evoked from the lower teeth and supporting tissues even after successful inferior dental and lingual nerve blocks have been administered. Infiltration injections are indicated in addition to the blocks, and are more suitable than other remote injections such as the long buccal injection. Inadequate analgesia of a lower central incisor after a single inferior dental block is due to fibres of the opposite mandibular nerve crossing the midline. This cross-innervation is most probably derived from nerves within the labial mental plexus and not the incisive nerves. Therefore, although a block of the opposite inferior dental nerve would be successful in achieving analgesia, an infiltration is preferable to avoid the possibility of supply from other nerves within the soft tissues, particularly for surgical procedures. There is a minimum volume of 2 per cent lignocaine solution, with 1 in 80 000 adrenaline, to be accurately administered for the induction of a successful inferior dental block and this has been shown to be 1·0 ml. Small volumes may produce symptoms of anaesthesia, but will allow some impulses to jump' the block. Larger volumes cause undue pressure rises within the tissues. There is a critical concentration of lignocaine with 1 in 80000 adrenaline, to achieve repeatable success with infiltration and block anaesthesia. This has been assessed as 2 per cent and clinical experience has confirmed this observation. However, when pathological changes occur, particularly with the development of acute inflammation, this concentration is sometimes inadequate. The slight degree of acidosis produced in inflamed tissue is not considered to be a major cause of failure to induce analgesia, the main factor being that inflammation has increased the action potential transmitted in the sensory nerves. Under these conditions an increased strength of lignocaine solution is usually effective in achieving pain control.

Production of local anesthesia by jet injection: A clinical study

A clinical survey of 500 cases indicates that the SyriJet Mark II jet injector is useful in providing topical anesthesia in all areas of the oral cavity. However, it was found not to be applicable for anesthetizing the posterior superior alveolar, inferior alveolar, or incisive nerves.