Comparison of inferior alveolar nerve anesthesia duration using the Conventional and Gow-Gates technique in patients referring to the Department of Oral and Maxillofacial Surgery: A Randomized Clinical Trial

The use of alternative approaches to supplement alveolar nerve anesthesia other than the conventional nerve block has received little attention by dental professionals, although they are associated with less complications compared with contemporary injections. This may partly be due to the small amount of research in this regard. The present study assessed the effectiveness of two techniques of conventional and Gow-Gates nerve blocks for inferior alveolar nerve anesthesia in patients referring to the Department of Oral and Maxillofacial Surgery at Shahid Beheshti University of Medical Sciences, Tehran. 

A randomized clinical trial was carried out on 120 patients requiring IAN anesthesia for mandibular posterior teeth extraction (60 cases for each technique). The injections were perfromed using two inferior alveolar nerve block techniques: the conventional and Gow-Gates block, selected by random order using standard protocol. The time required for the onset of anesthesia in different nerves was recorded according to the patient responses and the injection complications were noted. The data was subjected to Chi-square and Mann-Whitney U tests. 

The mean time required for anesthesia onset in all nerve blocks (inferior alveolar, mental, incisive, lingual, and long buccal) were significantly different between the two conventional and Gow-Gates techniques (p<0.001). Positive aspirations were shown in 1.7% of patients receiving Gow-Gates and 20% of patients in conventional techniques. Furthermore, 16.7% of patients required supplemental injections in the conventional method while there was no need for such injections in the Gow-Gates group. Also, 23.3% of teeth receiving Gow-Gates block and 13.3% in conventional technique required repeated injections. 

Although all the studied nerves received delayed anesthesia in Gow-Gates injections, the use of this technique is effective in maintaining successful inferior alveolar nerve anesthesia due to the reduced injection complications and less frequency of needed supplemental injections.