The Wyman Mandibular Block

Only use 25 gauge needle – 27 or smaller give poorer results

Anatomic structures involved:

1. Maxillary tuberosity2. Mandibular retromolar pad3. Pterygo-mandibular raphe4. Internal oblique ridge5. Lingual foramen

Wyman Block Landmarks

Maxillary tuberosity is joined by the Pterygo-mandibular raphe to the Mandibular retromolar pad Insertion point is 1/2 way between the

upper and lower arches, just lateral to the raphe

Syringe rests on contra-lateral maxillary first bicuspid

Lingual Foramen

Lies below the occlusal plane, but the traditional injection places the anaesthetic above the plane

Therefore the injection may fail up to 15 – 25% of the time

Wyman block places anaesthetic below the occlusal plane for 95 – 98% success

Internal oblique ridge

Anterior-lingual border of the ramus Significant obstruction to needle

placement Must be bypassed for effective

anaesthesia

Lingual foramen

Internal oblique ridge

Lingual Foramen

Internal oblique ridge

Anaesthetic

target area

Wyman Block Procedure

Locate point of insertion Position syringe over opposite side

and agitate cheek vigorously for distraction

Place syringe all at once and touch bone

SLOWLY inject up to one cartridge of anaesthetic

Wyman Block Notes:

Patient may remain reclined Mouth does not have to be propped

open during onset For buccal anaesthesia add a drop to

the disto-buccal papilla (not long buccal)

“Walking Drops” instead of long buccal

The Wyman Block is just one of many subjects covered in Roel Wyman’s exciting hands-on seminars. For information about seminars,

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