Mandibular versus inferior dental anaesthesia: clinical assessment of 3 different techniques

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 onset and duration of anaesthesia, pain during injection, aspiration test, pinprick, depth and frequency of anaesthesia. 90 patients undergoing simple tooth extraction were randomly selected into 3 groups. They were given injections of 2 ml of 2% lidocaine with adrenaline (1:80,000). All techniques were mostly painless, none of them showing any special advantage in that sense. The differences in duration of anaesthesia among the applied techniques were insignificant. Positive aspirations were most frequently observed with the direct method of inferior dental anaesthesia, but this method gave the best result for the frequency of anaesthesia. After using the Gow-Gates method, the external branches of the buccal nerve were usually anaesthetized but the onset of anaesthesia was relatively slow. Mandibular conduction anaesthesia via the tuberosity approach did not show any particular advantage over the other 2 techniques in this investigation. A progress study is needed to determine more precisely the aspiration rate and frequency of anaesthesia for all the techniques.