Is the Vazirani-Akinosi Nerve Block a Better Technique Than the Conventional Inferior Alveolar Nerve Block for Beginners?

Nakkeeran, Komagan Prabhu; Ravi, Poornima; Doss, Guruprasad Thulasi; Raja, Krishna Kumar

doi:10.1016/j.joms.2018.08.034

Cited by 17 publications

(17 citation statements)

References 8 publications

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“…15,20,21 In the present study, successful lidocaine IANBs were shown in 55% of cases operated by dental students, a figure which was comparable to what has been reported by other studies in the extraction setting. 2,9 This low rate of success compared to that obtained by experienced dentists, combined with the defected VAS assessment scores of anesthetic performance, indicates that the IANBs delivered by students had -in average-some technical flaws that lidocaine could not compensate for.…”

Section: Discussionmentioning

confidence: 97%

“…Ability to achieve successful anesthesia by the correct technique is an important skill to learn by dental students and a vital part in their competency assessment. 1,2 The most routinely used technique of local anesthesia for mandibular teeth is the inferior alveolar nerve block (IANB). Unfortunately, this technique has relatively high failure rates, and the most common reason of failure is poor technique.…”

Section: Introductionmentioning

confidence: 99%

“…5,8 In tooth extraction setting, studies have reported successful IANBs in 50% to 61% of the operated cases. 2,9 Articaine has gained a wide acceptance among dental surgeons as an effective local anesthetic with an excellent tissue diffusion profile. [10][11][12] Recent meta-analyses have provided a high quality evidence that articaine has superior anesthetic efficiency compared to lidocaine, and it could significantly increase the success rate of IANB in patients with irreversible pulpitis and those require lower third molar extraction.…”

Section: Introductionmentioning

confidence: 99%

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Articaine improves anesthetic achievement for exodontia performed by undergraduate dental students: A clinical comparative study

Muhammad

Abdullah

Majid

2021

Journal of Dental Education

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Purpose/objectives: To assess the clinical performance of undergraduate dental students in delivering inferior alveolar nerve block (IANB) with either articaine or lidocaine, and to compare the success rate of their IANBs between articaine and lidocaine for the extraction of mandibular molar teeth. Methods:In this clinical trial, patients were randomly distributed into 2 study groups: articaine and lidocaine groups. In each group, dental students performed IANB followed by forceps extraction of 1 mandibular molar under close supervision. The operative parameters measured included: assessment of anesthetic technique (on 10 points visual analogue scale 'VAS-10′), onset and depth of anesthesia, intra-operative pain perceived by patients and their satisfaction level (on VAS-10), and the success rate of IANB (in terms of need to additional anesthesia). Data analyses used were descriptive statistics, t-test, χ 2 test, and Pearson's correlation.Results: One-hundred sixty patients were included in the final analysis, 80 in each group. The overall students' IANB technique was assessed as good (mean score 7.3). Articaine group showed significantly higher success rate of IANB (71%) compared to (55%) in lidocaine group, (P = 0.03). Patients also reported significantly higher satisfaction scores in the articaine group (P = 0.04). There were no significant difference in the onset of action and intra-operative pain level between the 2 groups.Conclusions: Students' IANBs were generally assessed as "good." Articaine IANBs performed by undergraduate students showed significantly higher success rate than lidocaine IANBs. By using articaine, the anesthetic achievement was greater for mandibular molar extraction performed by undergraduate students.

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Section: Discussionmentioning

confidence: 97%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Articaine improves anesthetic achievement for exodontia performed by undergraduate dental students: A clinical comparative study

Muhammad

Abdullah

Majid

2021

Journal of Dental Education

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“…In light of the variable and high reported failure rates of IANB technique and its many possible complications [28,[34][35][36][37][38][39][40][41], alternative techniques were investigated in the literature [2,4,42]. However, most of these alternatives were complex and/or demanding special devices [2,4,30], and had their own complications [31][32][33].…”

Section: Discussionmentioning

confidence: 99%

The success of using 2% lidocaine in pain removal during extraction of mandibular premolars: a prospective clinical study

2020

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Background: The purpose of this study was to evaluate the anesthetic effectiveness of a buccal infiltration technique combined with local massage (using 2% lidocaine) in the extraction of mandibular premolars to be utilized as an alternative to the conventional inferior alveolar nerve block. Methods: Patients eligible included any subject with a clinical indication for tooth extraction of the mandibular 1st or 2nd premolars. All patients were anesthetized buccally by local infiltration technique followed by an external pressure applied for 1 min directly over the injection area. In each case, another local injection was given lingually. All operations were started at approximately 5 min after the buccal injection. The collected data included age, gender, pain perception and its intensity during treatment at three checkpoints, apical tenderness, and the type of extraction. Any associated complications or difficulties were also recorded. Then the results were analyzed and interpreted using appropriate statistical tests. The significance level was set at P ≤ 0.05. Results: A total of 247 cases (1st premolar, n = 119; 2nd premolar, n = 128), predominantly male, were included. In 95% of study sample, the patients were satisfied with the dental extraction without any pain. However, in 5% of cases, pain was reported at the stage of tooth removal. Apical tenderness was found to be present in 11% of the total cases. Three teeth required surgical removal. Upon analysis, no significant differences in the success rates were detected between the 2 premolar groups or amongst the various age groups. Minor and transient side effects were reported in this study. Conclusion: The technique is simple and effective as well. It might be considered as an alternative anesthetic injection to the inferior alveolar nerve block for dental extraction of the mandibular premolars.

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“…Literature review shows a gradual change in trend favoring Vazirani-Akinosi in recent years. 6 This can be due to adaption of this technique in educational institutions by dental practitioners and increased knowledge about anatomy and landmarks.…”

Section: Yücel and Hutchison 4 Did A Comparative Evaluation Of Conven...mentioning

confidence: 99%

Technique of Choice to Anesthetize Mandibular Nerve in Case of Maxillofacial Fractures

et al. 2019

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Achieving optimum pain control and anesthesia in maxillofacial fracture trauma individuals will be difficult in some scenarios because of change in position of landmarks due to fracture, trismus, and noncompliant nature of patient due to pain. We did a comparative evaluation of efficiency of inferior alveolar nerve block (IANB) and Vazirani-Akinosi closed mouth nerve block technique to anesthetize the inferior alveolar nerve in trauma patients with trismus and concluded that IANB is superior to Vazirani-Akinosi in terms of onset and efficacy but its application in trauma patients with reduced mouth opening is limited and Vazirani-Akinosi will be the technique of choice in case of such scenarios.

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Is the Vazirani-Akinosi Nerve Block a Better Technique Than the Conventional Inferior Alveolar Nerve Block for Beginners?

Cited by 17 publications

References 8 publications

Articaine improves anesthetic achievement for exodontia performed by undergraduate dental students: A clinical comparative study

Articaine improves anesthetic achievement for exodontia performed by undergraduate dental students: A clinical comparative study

The success of using 2% lidocaine in pain removal during extraction of mandibular premolars: a prospective clinical study

Technique of Choice to Anesthetize Mandibular Nerve in Case of Maxillofacial Fractures

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