title: Clinical evaluation of inferior alveolar nerve block by injection into the pterygomandibular space anterior to the mandibular foramen.
abstract: The conventional inferior alveolar nerve block (conventional technique) has potential risks of neural and vascular injuries. We studied a method of inferior alveolar nerve block by injecting a local anesthetic solution into the pterygomandibular space anterior to the mandibular foramen (anterior technique) with the purpose of avoiding such complications. The insertion angle of the anterior technique and the estimation of anesthesia in the anterior technique were examined. The predicted insertion angle measured on computed tomographic images was 60.1 +/- 7.1 degrees from the median, with the syringe end lying on the contralateral mandibular first molar, and the insertion depth was approximately 10 mm. We applied the anterior technique to 100 patients for mandibular molar extraction and assessed the anesthetic effects. A success rate of 74% was obtained. This is similar to that reported for the conventional technique but without the accompanying risks for inferior alveolar neural and vascular complications.
authors: Department of Anesthesiology, Nippon Dental University, School of Dentistry at Tokyo, 2-3-16 Fujimi, Chiyoda-ku, Tokyo 102-8158, Japan. takasugi@tokyo.ndu.ac.jp
authors: Y
authors: Y
authors: Takasugi
authors: H
authors: H
authors: Furuya
authors: K
authors: K
authors: Moriya
authors: Y
authors: Y
authors: Okamoto
mesh_terms: D000766:Anesthesia, Dental / Q000295:instrumentation / Q000379:methods; D000779:Anesthetics, Local / Q000008:administration & dosage; D005260:Female; D006801:Humans; D007267:Injections / Q000295:instrumentation; D008012:Lidocaine / Q000008:administration & dosage; D008297:Male; D008334:Mandible / Q000000981:diagnostic imaging; D008340:Mandibular Nerve; D008963:Molar; D009339:Needles; D009407:Nerve Block / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods*; D011187:Posture; D012307:Risk Factors; D013100:Sphenoid Bone / Q000000981:diagnostic imaging; D013223:Statistics as Topic; D018709:Statistics, Nonparametric; D016683:Supine Position; D013594:Syringes; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D014081:Tooth Extraction; D016896:Treatment Outcome; D061221:Trigeminal Nerve Injuries
chemical_list: D000779:Anesthetics, Local; D008012:Lidocaine