Clinical Evaluation of Inferior Alveolar Nerve Block

The conventional inferior alveolar nerve block technique (conventional technique) is generally delivered by inserting the needle tip toward and immediately above the mandibular sulcus or lingula. According to several reports, the needle tip must reach the proximity of the inferior alveolar nerve to ensure an anesthetic effect. However, the conventional technique is associated with risks and complications such as neural or vascular injury and intravascular injection.

We hypothesized that, by injecting a local anesthetic solution into the pterygomandibular space anterior to the mandibular foramen, where no large nerve or vessel is present, the anesthetic solution would diffuse inside the space and reach the inferior alveolar nerve, producing a sufficient inferior alveolar nerve block. In this study, we measured the insertion angle on computed tomographic (CT) images to confirm the direction of the anterior technique and applied this technique to mandibular molar extraction and assessed its clinical effects. canadian pharmacy online