Evaluation of a Nishit-Rama Modification of a Gow-Gates Technique for Giving Mandibular Nerve Block: A Randomized Controlled Trial.

Abstract

In pursuit of improving currently available anesthetic techniques for dental procedures, present study evaluated a novel mandibular nerve block technique in comparison with control group administered standard inferior alveolar nerve block (IANB) technique. A randomized, comparative, parallel design, double-blind study was conducted at Tata Main Hospital, Jamshedpur, India which enrolled 140 adult patients (70 in experimental group and 70 in control group) requiring minor surgical dental procedures involving normal forceps method extractions of mandibular molars. Tingling or numbness of the lower lip of the same side was considered suggestive of successful IANB blockage. Onset of anesthesia, aspiration of blood and failure of anesthesia were also assessed and compared between study groups. Mean age and gender distribution were statistically comparable between study groups (p > 0.05). Diagnosis of the enrolled cases was either acute or chronic apical periodontitis, which was distributed similarly in study groups (p > 0.05). Mean time to onset of the IANB blockage was found to be significantly longer in experimental group versus control (3.72 ± 0.84 versus 1.93 ± 0.62min, p < 0.05). Both, number of positive aspirations (7.14% versus 25.72%, p < 0.05) and need for additional injection were significantly lower in experimental group (18.58% versus 74.28%, p < 0.05). Incidence of pain while tooth removal was similar between study groups (p > 0.05). The novel technique for mandibular nerve block evaluated in present study has various advantages like avoidance of technical difficulties with absence of extra-oral landmark, lower chances of reinsertion reducing complication risk, and decreased systemic complications, evident by lower rates of aspirations.