Variants of inferior alveolar nerve block: A review

2014 ◽  
Vol 6 (1) ◽  
pp. 35-39 ◽  
Author(s):  
Rahul Seth ◽  
M. Anuradha ◽  
D.S. Yashavanth Kumar ◽  
Harsha V. Babji

Abstract The inferior alveolar nerve block is the most common method for obtaining mandibular anaesthesia in dental practice, but it is estimated to have a success rate of only 80 to 85%. Traditional anaesthesia of the mandibular nerve and its branches consists of deposition of anaesthetic solution in the region of the mandibular foramen. This commonly used technique eliminates all somatosensory perception of the mandible, mandibular teeth, floor of the mouth, ipsilateral tongue, and all but the lateral (buccal) gingivae. In the case of difficulty-to-anesthetize patient, the inferior alveolar nerve can be particularly challenging. In those patients, other approaches may be necessary to achieve profound anaesthesia. This article summarizes the different approaches that may be utilized in such cases. How to cite this article Anuradha M, Yashavanth Kumar DS, Harsha VB, Rahul S. Variants of inferior alveolar nerve block. CODS J Dent 2014;6;35-39

2014 ◽  
Vol 04 (03) ◽  
pp. 008-010
Author(s):  
Muralee Mohan ◽  
Tarun Jain ◽  
Rajendra Prasad ◽  
S M Sharma ◽  
Anju Gopinathan T.

Abstract Background and aims: It is a basic rule to aspirate before injection when giving an inferior alveolar nerve block because the local anaesthetic may fail if the injection is given into a blood vessel, and the local anaesthetic solution may have undesirable systemic effects. There are reports that indicate aspiration is not performed in every injection. The aim of the present study was to assess the incidence of intravascular needle entrance in inferior alveolar nerve block injections. Patients and methods: Interns and postgraduates of our institute performed inferior alveolar nerve block injections using conventional technique in 250 patients undergoing minor oral surgical procedures. The results of aspiration were reported. Aspirable syringes and 27 gauge long needles were used, and the method of aspiration was similar in all cases.Data were analyzed using t-test. Results: 20% of inferior alveolar nerve block injections were aspiration positive. Of all injections, 15.8% were intravascular on the right side and 14.8% were intravascular on the left. There were no statistically significant differences between right and left injection sites (P = 0.778). Between the ages of 9 and 19 the incidence of intravascular penetration was significantly greater than at other ages (10/28 compared with 39/222, P = 0.04). Conclusion: Aspiration of the syringe after the needle had been placed in position for an inferior alveolar nerve block (but before the anaesthetic solution was injected) in 250 patients showed that the tip of the needle was in a blood vessel in 49 (20%). Aspiration of blood was significantly more common in patients aged 9–19 years than in all others (P=0.04). It seems that side of injection has no considerable effect in incidence of intravascular needle entrance.


2016 ◽  
Vol 27 (4) ◽  
pp. 381-386 ◽  
Author(s):  
Carlos E. Allegretti ◽  
Roberta M. Sampaio ◽  
Anna C. R. T. Horliana ◽  
Paschoal L. Armonia ◽  
Rodney G. Rocha ◽  
...  

Abstract Inferior alveolar nerve block has a high failure rate in the treatment of mandibular posterior teeth with irreversible pulpitis. The aim of this study was to compare the anesthetic efficacy of 4% articaine, 2% lidocaine and 2% mepivacaine, all in combination with 1:100,000 epinephrine, in patients with irreversible pulpitis of permanent mandibular molars during a pulpectomy procedure. Sixty-six volunteers from the Emergency Center of the School of Dentistry, University of São Paulo, randomly received 3.6 mL of local anesthetic as a conventional inferior alveolar nerve block (IANB). The subjective signal of lip numbness, pulpal anesthesia and absence of pain during the pulpectomy procedure were evaluated respectively, by questioning the patient, stimulation using an electric pulp tester and a verbal analogue scale. All patients reported the subjective signal of lip numbness. Regarding pulpal anesthesia success as measured with the pulp tester, the success rate was respectively 68.2% for mepivacaine, 63.6% for articaine and 63.6% for lidocaine. Regarding patients who reported no pain or mild pain during the pulpectomy, the success rate was, respectively 72.7% for mepivacaine, 63.6% for articaine and 54.5% for lidocaine. These differences were not statistically significant. Neither of the solutions resulted in 100% anesthetic success in patients with irreversible pulpitis of mandibular molars.


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