Evaluation of the anesthetic efficacy of inferior alveolar nerve blocks in dental patients - A Systematic Review

The inferior alveolar nerve (IAN) block is the most frequently used mandibular injection technique for achieving local anesthesia for dental treatment. However, the IAN block does not always result in successful anesthesia. Various other nerve blocks were introduced over the period of time to improve the success rate of anesthesia. The objective of this systematic review was to compare and evaluate the anesthetic efficacy of Inferior alveolar nerve block with various mandibular nerve blocks in dental patients. Electronicdatabases were systematically searched for randomized controlled clinical studies and Clinical trials studies. Studies were selected by predefined inclusion criteria. Methodological quality was appraised and strength of evidence was determined. Seven studies from seven countries were included based on inclusion criteria. Although there is difference in the values comparing the different techniques the data is not significantly different in the anesthetic efficacy of various mandibular nerve block in dental patients. Based on this review, most of the articles included, point towards a better anesthetic efficacy of the classic inferior alveolar nerve block compared to the other inferior alveolar anesthesia techniques. However due to various variables like type of local anesthesia, experience of the operator and familiarity with the individual techniques it is not possible to conclude that classic inferior alveolar nerve block is relatively superior. Hence further research should be aimed at better matching of groups and variables like operator experience and familiarity to validate the findings.