What is the primary landmark for the inferior alveolar nerve block?

• A. Mandibular midline
• B. Pterygomandibular raphe and the coronoid notch (near the mandibular foramen)
• C. Zygomatic process
• D. Buccal mucosa at the first molar

Answer: (B)

The key idea is how to locate the pathway to the inferior alveolar nerve using specific facial landmarks. For this block, you orient to the pterygomandibular space with two boundaries: the coronoid notch and the pterygomandibular raphe. The coronoid notch is the deepest inward bend on the anterior border of the mandibular ramus, giving you the front boundary. The pterygomandibular raphe provides the rear boundary. Together, they define the usable window through which you aim the needle toward the mandibular foramen to reach the inferior alveolar nerve.

Other options don’t establish the correct access route: the mandibular midline isn’t used to guide this injection, the zygomatic process isn’t involved in locating the nerve’s entry point, and injecting at the buccal mucosa near a first molar targets the buccal area rather than the nerve that enters the mandible.