Buccal nerve dissection via an intraoral approach: correcting an error regarding buccal nerve blockade

Publication date: Available online 5 February 2019

Source: Journal of Oral and Maxillofacial Surgery

Author(s): Joe Iwanaga, R. Shane Tubbs

Abstract

Purpose

The buccal nerve (BN) supplies sensation to the skin over the anterior part of the buccinator and the buccal mucosa, as well as the buccal gingivae corresponding to the second and third molar teeth. Some dental anatomy books show the main trunk of the BN coursing over the buccal shelf of the mandible, which leads to a significant misunderstanding of this anatomy. Therefore, this study aims to reveal the course of the BN on the retromolar area and establish new evidence based anatomy for appropriate buccal nerve blockade.

Methods

Twenty sides from ten fresh-frozen Caucasian cadaveric heads were used in this study. The closest distance from the BN to the injection site of the buccal nerve blockade (Dis A) was measured.

Results

The mean Dis A was 12.69±2.95 mm. On 16 of 20 sides (80%), Dis A was greater than 10 mm. In the majority of specimens, the injection site of the buccal nerve blockade was too far from the course of the main trunk of the BN and the injection site should be changed to 10 mm superolateral to the injection site based on our results and other previous studies.

Conclusion

Although the distribution of the BN is variable, in the majority of our specimens, the current injection site for BN blockade was too far from the course of the BN.

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