Gow-Gates Technique: A Pilot Study for Extraction Procedures With Clinical Evaluation and Review

Abstract

The aim of this study was to compare the effectiveness of 2 different volumes of anesthetic solution for a premolar-molar extraction, and to determine the onset of complete mandibular conduction anesthesia via a Gow-Gates mandibular block. One operator performed 32 blocks with a 27-gauge needle on patients who required a dental extraction: 16 blocks using 1.8 mL of anesthetic solution, and 16 blocks using 3.6 mL of anesthetic solution. The parameters evaluated were frequency of successful anesthesia and onset of complete anesthesia. Significant differences (P < .005) were observed in the evaluation of volume: the 3.6 mL group yielded a higher success rate (82.5%) than the 1.8 mL group (17.5%). The onset of complete conduction anesthesia was achieved in 8 minutes by 56% of the subjects (9 of 16) with 3.6 mL and only one subject in 16 (6%) with 1.8 mL. A larger volume of anesthetic solution (3.6 mL) is required to achieve a higher success rate and a faster onset of action for a dental extraction without the use of reinforcement anesthesia. The volume of anesthetic solution is indirectly proportional to the onset of complete anesthesia. A premolar-molar extraction can be done, with 3.6 mL of anesthetic solution, in more than 50% of the patients 8 minutes after injection.

Comparative Evaluation of 1.8 mL and 3.6 mL of 2% Lidocaine with 1:200,000 Epinephrine for Inferior Alveolar Nerve Block in Patients with Irreversible Pulpitis: A Prospective, Randomized Single-blind Study

“…Takeuchi (25), on the basis of a computed tomography scan study, reported an average volume of 1.27 AE 0.59 mL with the mouth closed and 1.99 AE 0.4 mL with the mouth opened. Some authors using the Gow-Gates technique have reported that volumes more than 1.8 mL produce better success rates than 1.8 mL of 2% lidocaine solution (16,26). Kohler et al (16) reported a significant increase in the success rate while using 3.6 mL of 2% lidocaine hydrochloride with 1:100,000 epinephrine as compared with 1.8 mL of the solution.…”

“…Murphy and Grundy (15) estimated the volume of the pterygomandibular space to be approximately 2.0 mL. Kohler et al (16) suggested from a clinical observation that two 1.8-mL cartridges (3.6 mL) more adequately fill the pterygomandibular space. Madrid et al (17) reported that the ''volume of the pterygomandibular space is quite superior to the value usually reported in the dental literature.''…”

Gow-Gates Mandibular Nerve Block Anesthesia: Is It an Old Forgotten Technique?

“…한다 (Goldberg et al, 2008;Malamed, 2004;Waikakul and Punwutikorn, 1991). (Cohen et al, 1993Kohler et al, 2008Levy, 1981;Malamed, 1981;Montagnese et al, 1984;Sisk, 1985;Watson andGow-Gates, 1976 Zandi andSabounchi, 2008 …”

Efficacy of the Gow-Gates and Inferior Alveolar Nerve Block Techniques in Providing Anesthesia During Surgical Removal of Impacted Lower Third Molar: A Controlled Randomized Clinical Trial

“…Nevertheless, onset of anesthesia is slower in the GGB (five to ten minutes) in comparison with the IANB (7). Although some studies reported that the success rate of the GGB was more than the IANB (7,11,17,18), others showed that both techniques had the same success rate (20,21) and in some cases, the IANB had a higher success rate (19).…”