Further observations on mandibular anaesthesia

Recent studies have emphasized that none of the accepted intraoral landmarks used in the conventional mandibular block technique is completely reliable, nor can they presage those instances in which the lingula presents an obstruction to the needle pathway. An answer to this problem is suggested by the use of extraoral landmarks to assist in estimating the height and expected depth of needle penetration. The importance of palpating for the anterior border of the medial pterygoid muscle deep in the pterygotemporal depression is reaffirmed.