(TC64) Masseteric and Deep Temporal Nerve Block For The Management of Myogenous Pain.

One in every four Americans has experienced some form of oral and facial pain in their lifetime. A common diagnostic conundrum for endodontists and general dentists is the differentiation between odontogenic and non-odontogenic pain. Myogenous pain is the most common non-odontogenic orofacial pain. Young et al. (2009) introduced the “Twin Block,” an extraoral anesthetic technique targeting the masseteric and deep temporal nerves to reduce mandibular condyle dislocation. Since then, numerous studies have shown this technique effectively mitigates myogenic pain. Other advantages include the ease of application and the lack of major blood vessels in the needle's path. Because this anesthetic technique does not provide dental anesthesia, we believe it can be an essential diagnostic tool for endodontists to differentiate dentoalveolar from musculoligamentous sources of pain. This technique can also provide temporary relief for patients diagnosed with myogenous pain until they can see an orofacial pain specialist. Another practical application would be to deliver the masseteric and deep temporal nerve block before dismissing the patient when muscular pain is evident after prolonged mouth opening. This table clinic will demonstrate the technique by identifying relevant anatomical landmarks to perform the masseteric and deep temporal nerve block properly using visual aids. We will present the advantages of this technique and relevant applications. We believe that the TWIN Block technique is an essential tool for dental and endodontic practitioners.