Anesthetic Efficacy of Inferior Alveolar Nerve Block: Conventional versus Akinosi Technique

Anesthetic techniques like the Akinosi technique were introduced to surmount the problems of the conventional inferior alveolar nerve block (IANB) technique. This study aimed to compare the local anesthetic efficacy of IANB via the conventional and Akinosi techniques in patients presenting to the Maxillofacial Surgery Department of School of Dentistry, Shahid Beheshti University. This clinical trial was conducted on 80 candidates for bilateral extraction of mandibular molars. For each patient, local anesthesia was induced by IANB injection, which was done by the conventional technique in one side and by the Akinosi technique in the other side of the mouth. The allocation of technique to side was randomized. Time to anesthesia for the long buccal, lingual and inferior alveolar nerves (IAN), degree of pain during injection and tooth extraction and incidence of positive aspiration in the two techniques were evaluated and analyzed using Wilcoxon Signed Rank and Chi square tests. The mean time to anesthesia for the IAN was 2.82 minutes in the conventional and 3.05 minutes for the Akinosi technique. These values were 1.47 and 1.55 minutes, respectively for the lingual nerve and 1.43 and 1.56 minutes, respectively for the long buccal nerve. Four patients in the Akinosi technique and 12 patients in the conventional technique had positive aspiration. During anesthetic injection with the Akinosi technique, 72.5% were pain free, 18.8% experienced mild, 5% experienced moderate and 3.8% experienced severe pain. These values in the conventional technique were 51.3%, 27.5%, 11.3% and 10%, respectively. Considering the lack of a significant difference between the success rate of conventional and Akinosi IANB techniques, Akinosi technique seems to be a suitable alternative to the conventional technique since it is less painful and has lower risk of positive aspiration.