The influence of mandibular skeletal characteristics on inferior alveolar nerve block anesthesia
Tae Min You1, Kee-Deog Kim2, Jisun Huh2
1Department of Advanced General Dentistry, College of Dentistry, Dankook University, Cheonan, Korea.
Background:
The inferior alveolar nerve block (IANB) is the most common anesthetic techniques in dentistry; however, its success rate is low. The purpose of this study was to determine the correlation between IANB failure and mandibular skeletal characteristics.
Methods:
In total, 693 cases of lower third molar extraction (n = 575 patients) were examined in this study. The ratio of the condylar and coronoid distances from the mandibular foramen (condyle-coronoid ratio [CC ratio]) was calculated, and the mandibular skeleton was then classified as normal, retrognathic, or prognathic. The correlation between IANB failure and sex, treatment side, and the CC ratio was assessed.
Results:
The IANB failure rates for normal, retrognathic, and prognathic mandibles were 7.3%, 14.5%, and 9.5%, respectively, and the failure rate was highest among those with a CC ratio < 0.8 (severe retrognathic mandible). The failure rate was significantly higher in the retrognathic group than in normal group (P = 0.019), and there was no statistically significant difference between the other two groups.
Conclusions:
IANB failure could be attributable, in part, to the skeletal characteristics of the mandible. In addition, the failure rate was found to be significantly higher in the retrognathic group.
Related Concept Videos
Local Anesthetics: Differential Sensitivity of Nerve Fibers
Local Anesthetics: Clinical Application as Surface, Infiltration, and Conduction Block Anesthesia
Local Anesthetics: Clinical Application as Spinal Anesthesia
Local Anesthetics: Clinical Application as Intravenous Regional Anesthesia
One of the advantages of...
Cranial Nerves: Types Part I
Olfactory Nerve (Cranial Nerve I)
The olfactory nerve, or cranial nerve I, is unique as it is purely sensory and dedicated to the sense of smell. This nerve originates in the olfactory epithelium of the...
Local Anesthetics: Mechanism of Action
Local anesthetics are amphiphilic molecules consisting of a hydrophobic aromatic part linked to a hydrophilic group by an ester or amide linkage. They are weak bases and are usually available as salts, which increases their solubility and stability. Once administered, LAs exist in the body either...


