Pathways of insertion.

Each day, many dental procedures are successfully performed with local anesthesia. Their use is so commonplace that it would be difficult to imagine performing dentistry without them. The vast array of local anesthetics and the techniques for their delivery has allowed patients the opportunity to have dental treatment performed efficiently and comfortably. Yet, the practitioner cannot become complacent in their usage. The complex muscular, vascular, neural, and osseous interrelationships in the oral and craniofacial area mandate a thorough knowledge of this region. The purpose of this article is to review these relationships relative to the ability to obtain and maintain anesthesia. Further, blood vessels and other anatomic entities about which the deposition of local anesthesia should be made cautiously will be discussed.