• Daniel A Haas.
• Faculty of Dentistry, University of Toronto, 124 Edward St., Toronto, Ontario, M5G 1G6, Canada. daniel.haas@dentistry.utoronto.ca
• J Am Dent Assoc. 2011 Sep 1; 142 Suppl 3: 8S-12S.

Backgroundand Overview. The limited success rate of the standard inferior alveolar nerve block (IANB) has led to the development of alternative approaches for providing mandibular anesthesia. Two techniques, the Gow-Gates mandibular nerve block and the Akinosi-Vazirani closed-mouth mandibular nerve block, are reliable alternatives to the traditional IANB. The Gow-Gates technique requires the patient's mouth to be open wide, and the dentist aims to administer local anesthetic just anterior to the neck of the condyle in proximity to the mandibular branch of the trigeminal nerve after its exit from the foramen ovale. The Akinosi-Vazirani technique requires the patient's mouth to be closed, and the dentist aims to fill the pterygomandibular space with local anesthetic.ConclusionBoth techniques are indicated for any type of dentistry performed in the mandibular arch, but they are particularly advantageous when the patient has a history of standard IANB failure owing to anatomical variability or accessory innervation.Clinical ImplicationsHaving the skill to perform these alternative anesthetic techniques increases dentists' ability to provide successful local anesthesia consistently for all procedures in mandibular teeth.

13 keywords...

hide…