Efficacy and complications associated with a modified inferior alveolar nerve block technique. A randomized, triple-blind clinical trial

Marta Montserrat-Bosch, Rui Figueiredo, Pedro Nogueira-Magalhães, Josep Arnabat-Dominguez, Eduard Valmaseda-Castellón, Cosme Gay-Escoda, Marta Montserrat-Bosch, Rui Figueiredo, Pedro Nogueira-Magalhães, Josep Arnabat-Dominguez, Eduard Valmaseda-Castellón, Cosme Gay-Escoda

Abstract

Objective: To compare the efficacy and complication rates of two different techniques for inferior alveolar nerve blocks (IANB).

Study design: A randomized, triple-blind clinical trial comprising 109 patients who required lower third molar removal was performed. In the control group, all patients received an IANB using the conventional Halsted technique, whereas in the experimental group, a modified technique using a more inferior injection point was performed.

Results: A total of 100 patients were randomized. The modified technique group showed a significantly higher onset time in the lower lip and chin area, and was frequently associated to a lingual electric discharge sensation. Three failures were recorded, 2 of them in the experimental group. No relevant local or systemic complications were registered.

Conclusions: Both IANB techniques used in this trial are suitable for lower third molar removal. However, performing an inferior alveolar nerve block in a more inferior position (modified technique) extends the onset time, does not seem to reduce the risk of intravascular injections and might increase the risk of lingual nerve injuries.

Conflict of interest statement

Conflict of interest statement: The authors have declared that no conflict of interest exist.

Figures

Figure 1
Figure 1
A) Conventional IANB using the technique described by Halsted.
Figure 2
Figure 2
B) Modified IANB using a lower injection location.
Figure 3
Figure 3
Flow diagram with the patients included in each stage of the trial.

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Source: PubMed

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