Dr. Deepa B v, Dr. Rajesh Kumar B P, Dr. Chandan S N


Background and Objectives: Inferior dental anesthesia is administered regularly in dental practice. Modification of conventional Inferior
alveolar nerve block was introduced by Akinosi and Gow-Gates in which anesthesia of all the three branches of mandibular nerve can be obtained.
This study aims to compare and clinically assess the three different techniques of mandibular nerve block.
Method: A total of 300 patients who presented for minor oral surgical procedure (extraction or surgical removal of impacted tooth) were enrolled
and randomly divided into 3 groups. Each group was given injection of 3ml of 2% lidocaine with 1:80,000 adrenaline solution by using three
different techniques for mandibular block anesthesia. The patients were evaluated using parameters like pain during injection, positive aspiration,
depth of anesthesia, onset and duration of anesthesia.
Results: No significant difference was found between the groups in pain experienced during the injection and depth of anesthesia. Akinosi
technique achieved better buccal nerve anesthesia compared to Gow-Gates (P=0.03). The onset of anesthesia was significantly slower (P<0.001)
with the Gow-Gates technique in comparison with the other two methods. And Classical technique was significantly quicker in the onset of
anesthesia among the three techniques (P=0.001). Akinosi technique had a lower duration of action compared to the other two techniques.
Conclusion: The Classical inferior alveolar technique is effective in inducing profound mandibular anesthesia, it produces anesthesia at a faster
rate and also has a reasonable duration of action. A decision to select one of these techniques should be based on the ability to determine the
techniques respective to the anatomical landmarks, the need to anesthetize the buccal nerve, trismus or a marked gag reflex.


Mandibular nerve block; Gow-Gates; Akinosi; Inferior alveolar nerve block

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