Risk Factors of Inferior Alveolar Nerve Block Failure: A Dental Student-Centred Study
Gökhan Gürses1, Emine Taşkin1, Ahmet Akti1
1Department of Oral and Maxillofacial Surgery, Dentistry Faculty, Selçuk Üniversity, Konya, Türkiye.
Introduction:
The inferior alveolar nerve block (IANB) is the most widely used mandibular anaesthesia technique; however, it remains prone to failure due to both anatomical and operator-related factors. Understanding these factors is essential to enhancing student training and patient comfort. This study aimed to identify risk factors associated with IANB failure among dental students.
Materials And Methods:
A prospective observational study was conducted at Selcuk University Faculty of Dentistry (February 2023-July 2024). Fourth- and fifth-year right-handed dental students administered IANBs to 340 patients using the Halstead technique with 4% articaine and epinephrine. Anaesthesia success was evaluated after 10 min through both clinical testing and patient feedback by a blinded assessor. Logistic regression analyses identified significant predictors of failure, while receiver operating characteristic (ROC) curves assessed discriminative performance.
Results:
Out of 340 procedures, 301 were successful, yielding an overall success rate of 88.5%. Failures were associated with limited interincisal opening, higher body mass index (BMI) and lower student experience level. Multiple logistic regression confirmed these three as independent predictors (p < 0.05). Among these, BMI showed the strongest predictive performance (AUC = 0.72), followed by interincisal distance (AUC = 0.68) and student grade (AUC = 0.66).
Conclusion:
IANB success depends on both operator experience and patient morphology. Incorporating structured psychomotor and simulation-based anaesthesia training early in dental education may reduce failure rates and improve clinical proficiency.
