The inferior alveolar and mylohyoid nerves: an anatomic study and relationship to local anesthesia of the anterior mandibular teeth.

The distance between the branching point of the mylohyoid nerve to the entrance of the inferior alveolar nerve into the mandibular canal was studied in 37 adult human cadavers. On the average, this branching distance was 14.7 mm, which is greater than previously reported. Also found was a 43% incidence of extension of the mylohyoid nerve beyond the muscle to foramina on the lingual aspect of the mandible. If the mylohyoid nerve mediates sensory information from the anterior incisors, then the factor of an increased branching distance may become important in terms of the dilution of the anesthetic agent during diffusion and the amount of nerve length exposed to the anesthetic agent. These findings may also account in part for the purported greater success of the so-called Gow-Gates type of injection technique compared with that of the conventional mandibular block.