Figure 1.
Motor driven battery powerd intraosseous drill device (equipped with 15mm needle).
Figure 2.
Area of the left lower jaw where the puncture should start at the bone level.
The marked red area defines the borders within the procedure should be performed to avoid injury of the mental nerve. The position of the canine tooth C may facilitate choosing the drilling direction. M: midline F: foramen mentale.
Figure 3.
Position of the needle tip shown at a living female.
Note, that the thumb and index finger stabilize the anterior lower jaw and facilitate the estimation of a correct drilling direction which is approximately 45 degrees towards the assumed root axis of the lower front teeth. The canine tooth is marked with *.
Table 1.
Dental and medical students performing intraosseous vascular access by use of battery driven drill system.
Figure 4.
Buccal ink extravasation (asterisks) after intraosseous puncture of the left anterior mandible approximately half way between midline and the suspected area of the formamen mentale.
In the upper figure inlet a vessel staining indication vascular deposition of ink is demonstrated. The arrows point to stained vessels.
Figure 5.
Floor of mouth extravasation of ink after injection through an intraosseos puncture needle placed in the left anterior mandible area.
Similar staining of vessels in the inferior alveolar canal of the mandible.
Figure 6.
Time needed to perform an intraosseous vascular access using a battery driven intraosseous drill device.
Dent – dental students n = 17, Med – medical students n = 16.
Figure 7.
Multiplanar CT reconstruction and surface rendered image showing vessels (right to the asterisk) after barium sulfate injection into an intraosseous access placed into the left anterior mandible.
Figure 8.
Vessels of the lower lip stained by injection of green dye into a mandibular intraosseous vascular access.
Figure 9.
CT scan of a separate experiment is showing a successful puncture ending at the cortical layer of the left anterior mandible.