A Clinical Comparison of Three Techniques of Mandibular Local Anaesthesia

Aim: Inferior dental anaesthesia via the direct intraoral approach, mandibular conduction anaesthesia via extraoral landmarks (Gow-Gates) and mandibular conduction anaesthesia via the tuberosity approach (Akinosi) were evaluated using pain during injection, aspiration test, pinprick, depth and frequency of anaesthesia, onset and duration of anaesthesia. Materials and Methods: 120 patients of both sexes, aged from 16 years to 50 years undergoing mandibular molar tooth extraction were included. They were randomly designated into 3 groups with regards to the applied technique of mandibular anaesthesia. Each patient was given injection of 2 ml of 2% lignocaine with adrenaline (1:80,000) using 2ml disposable syringes and a 25 gauge, 1.5 inch needle. Results: Classical inferior nerve block showed greater incidence of pain among the applied techniques. Positive aspiration was most frequently observed with classical inferior nerve block. The onset of anaesthesia was found to be slower with Gow-Gates technique while duration of anaesthesia was longer. Mandibular conduction anaesthesia via the tuberosity approach did not show any particular advantage over the other two techniques in this study. Conclusions: After using Gow-Gates method, it was found that the Gow-Gates technique is a highly successful alternative to the conventional inferior nerve block with regards to increased success rate, constancy of landmarks, decreased positive aspiration rate, decreased incidence of complications such as trismus, the advantage of one injection to anaesthetize a greater area supplied by the mandibular nerve, longer duration of anaesthesia and less amount of pain experienced during injection.