Abstract
Objective: To determine the effectiveness of Extra oral inferior alveolar nerve block (IANB) technique in terms of pain during injection, onset of anesthesia and pain during extraction of mandibular teeth.
 Methodology: This cross sectional study was carried out at the department of Oral & Maxillo-facial Surgery, Institute of Dentistry, Liaquat University of Medical & Health Sciences Jamshoro / Hyderabad, from May 2018 to November 2018. All patients in the age range of 18-45 years regardless of gender and having sub-mucous fibrosis were included. Affected teeth were diagnosed via clinical examination, intra oral periapical radiograph (IOPAR) and Orthopantomogram (OPG). Mandibular teeth were anesthetised by extra oral inferior alveolar nerve block. Visual analog scale was used to record severity of the pain during the injection of anesthesia and during the extraction. Onset of the anesthesia was recorded in minutes. Data was documented via self-made proforma and analyzed by SPSS 20 version 20.
 Results: Overall 64 cases were studied. Out of which 34 were males and 30 were females. In most of the cases pain was not found, while 8 cases showed mild pain and 4 showed moderate pain. During extraction, there was no pain among 46 patients, while 10 had mild pain and only 8 had moderate pain.
 Conclusion: It was concluded that extra oral inferior alveolar nerve block technique is the best treatment option with less pain during injection, rapid onset of anesthesia, and less pain during extraction.
Highlights
In dental procedures, injecting the local anesthetic agents into the mucous membrane and skin is the most prevalent method to perform a pain free procedure
It was concluded that extra oral inferior alveolar nerve block technique is the best treatment option with less pain during injection, rapid onset of anesthesia, and less pain during extraction
An intra-oral injection method of inferior alveolar nerve block is prevalent for local anesthesia and often leads to effective pulpal anesthesia [2]
Summary
In dental procedures, injecting the local anesthetic agents into the mucous membrane and skin is the most prevalent method to perform a pain free procedure. These minor and painful processes have an apparent advantages for both surgeon and patient in minimizing the patient's pain in course of operation [1]. Extra-oral inferior alveolar nerve block indications include the anesthetising of entire mandibular nerve distribution for extensive surgical procedure in which intra-oral inferior alveolar nerve block (IANB) cannot be performed, due to presence of trismus, local infection and further conditions that make block of inferior alveolar nerve's terminal branches further problematic or impossible. Mentioned types of block anesthesia are useful, easy, safe, and having less complications to reduce the morbidity, help to improve patient’s quality of life and reduces the total cost of the treatment in patient particular and society at large
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