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Injection landmark trainer

Eleven injections: the target landmark, where the needle goes in, what goes numb and what is at risk. Learn them on the drawings, tap the target, then test yourself.

Inferior alveolar nerve block (IANB): target, needle path and numb areaSeen from inside the mouth: ramus and condyle on the left, chin (symphysis) on the right. The mandibular foramen and lingula sit mid-ramus, with the mylohyoid groove running down and forward from them.
Seen from inside the mouth: ramus and condyle on the left, chin (symphysis) on the right. The mandibular foramen and lingula sit mid-ramus, with the mylohyoid groove running down and forward from them.
  1. mandibular foramen and lingula
  2. coronoid notch
  3. condylar neck (medial side)
  4. lingual nerve region
  5. mylohyoid groove
Anatomy adapted from Gray's Anatomy (1918), public domain.

target needle path roughly what goes numb (as seen on this view)

Not drawn: the pterygomandibular raphe, a soft-tissue band from the pterygoid hamulus to the back of the mylohyoid line, behind the last molar. The needle enters just lateral to it, at coronoid-notch height, and runs from the opposite premolars (anterior and medial) back to the mandibular foramen.

Inferior alveolar nerve block (IANB): needle path on the outer (lateral) viewFace toward the left, teeth together. Targets on the inner (medial) side of the ramus are drawn as dashed rings.
Outer view for orientation: the needle enters at the height of the coronoid notch and passes medial to the ramus (dashed) to the mandibular foramen.Anatomy adapted from Gray's Anatomy (1918), public domain.
Target
Mandibular foramen (near the lingula, medial ramus)
Needle insertion
Lateral to the pterygomandibular raphe at the height of the coronoid notch, 6–10 mm above the mandibular occlusal plane; barrel over the opposite premolars; contact bone at about 20–25 mm
Anesthetizes
Mandibular teeth to the midline, body of the mandible, buccal tissue anterior to the mental foramen, and (lingual nerve) the anterior two-thirds of the tongue, floor of mouth and lingual gingiva
Structures at risk
Inferior alveolar artery and vein (positive aspiration is common), and the parotid gland with the facial nerve if deposited too far posteriorly
Pearl
Buccal soft tissue of the molars is NOT covered; add a long buccal injection for molar extractions.

Bone drawings: engravings from Henry Gray, Anatomy of the Human Body (20th ed., 1918), public domain, with the text labels removed; markers placed for this site. Soft tissue (mucosa, the pterygomandibular raphe, nerves) is not drawn, so those positions are approximate. Technique details follow standard dental local anesthesia teaching (Malamed, Handbook of Local Anesthesia); your school's technique may differ in detail.