Inferior alveolar nerve block anesthesia via the retromolar triangle, an alternative for patients with blood dyscrasias

• Published in: Medicina oral, patología oral y cirugía bucal Vol. 13; no. 1; p. E43
• Main Authors: Suazo Galdames, Iván Claudio, Cantín López, Mario Gonzalo, Zavando Matamala, Daniela Alejandra
• Format: Journal Article
• Language: English
• Published: Spain 01-01-2008
• Subjects: Adult; Aged; Anesthesia, Dental - methods; Bicuspid - innervation; Blood Coagulation Disorders - complications; Female; Humans; Male; Mandibular Nerve; Middle Aged; Molar - innervation; Nerve Block - methods; Time Factors
• ISSN: 1698-6946

One of the most commonly used mandibular anesthesia techniques is the Spix technique, which is very useful in clinical practice, but is risky when the patient is a bearer of blood dyscrasias.
The aim of this study was to present an alternative to the Spix technique in order to achieve troncular anesthesia of the inferior alveolar nerve. To this purpose, an infiltrative technique was designed to anesthetize the inferior alveolar nerve via the retromolar triangle.
This study included 40 patients with an average age of 23.65 years, 22 males and 18 females, who were previously evaluated with a vitalometer control, then subjected to the designed anesthetic technique. The effectiveness of the technique used to anesthetize the inferior alveolar nerve was evaluated by the results of tests using a vitalometer applied to a molar and a premolar on the anesthetized side after 5, 10 and 15 minutes. Moreover, the anesthesia was evaluated in mucosa innervated regions by the inferior alveolar, lingual and buccal nerves, and by having the patient relate the duration of the induced feeling of numbness.
The technique proved to be effective in 72.5% of the cases, with a latency of 10 minutes and an average duration of the anesthetic effect for 141.125 minutes. Moreover, anesthesia was obtained in the mucosa innervated regions by the inferior alveolar nerve in 72.5% of the cases, by the buccal nerve in 27.5% and in the innervated areas by the lingual nerve in 55% of the cases.
The proposed technique, even when it proved to be less effective than the Spix technique, can be seen as a lower risk alternative for patients carrying blood dyscrasias and being subjected to dental procedures in mandibular teeth.