Clinical Evaluation of Inferior Alveolar Nerve Block: RESULTS

11 Feb 2010

Insertion Angle

The predicted insertion angles were 60.1 ± 7.1° (mean ± SD) in the anterior technique and 49.7 ± 5.3° in the conventional technique. There was a significant difference (Figure 2).

Clinical Evaluation

Table 1. Clinical results of the anterior technique (number of patients in parentheses); grade A, completely satisfactory analgesia; grade B, subject feels slight pain but does not require reinforcement; grade C, feeble analgesia, another injection required;

	All	Sitting	Supine
	Patients	Group	Group
	(n = 100)	(n = 53)	(n = 47)
	(%)	(%)	(%)
Grade A	64	62 (33)	66 (31)
Grade В	12	15 (8)	9(4)
Successful grades:
A + В	76	77 (41)	75 (35)
Grade С	23	21 (11)	26 (12)
No symptoms	1	2(1)	0(0)

Sixty-four percent of the patients were evaluated as grade A, 12% as grade B, and 24% as grade С (no anesthetic effect in one patient), with a success rate (grades A and B) of 76%. No significant differences between the two postural groups were detected (Table 1).
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Figure 2. Comparison of the insertion angles

Table 2. Onset time of the anterior technique in grades A and B; values are median (25th percentile, 75th percentile, range)

	All Patients	Sitting Group	Supine Group
	(n = 76)	(n = 41)	(n = 35)
	(minutes)	(minutes)	(minutes)
Subjective
Tongue numbness	2 (1, 3, 0.5-9)	2 (2, 3, 0.5-9)	2 (1, 2, 1^1)
Lower lip numbness*	3 (2, 5, 0.5-12)	3 (2, 6, 0.5-12)	2 (1, 4, 1-10)
Stick test (complete numbness of
lower lip)	4 (2, 7, 0.5-9)	5 (2, 7, 0.5-13)	3 (2, 6, 1-19)
Time lapse between the initial in-
jection and the start of surgery	9 (6.75, 14.25, 3-27)	9 (7, 11, 3-19)	10 (6.5, 18, 3-27)
* There was a significant difference between the sitting group and the supine group in the mean onset time of lower lip numbness
(P < .05).

In patients with grades A and B, the median onset time of numbness in the tongue was 2 minutes (30 sec-onds-9 minutes), numbness in the lower lip was 3 minutes (30 seconds-12 minutes), and the onset time of analgesia in the lower lip was 4 minutes (30 seconds-19 minutes). Median time lapse between the initial injection and the start of extraction was 9 minutes (3-27 minutes). There was a significant difference between groups in the onset time of lower lip numbness (Table 2).
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