Modification in implementation of the inferior alveolar nerve block technique

Abstract Purpose: The inferior alveolar nerve block (IANB) is a necessary and frequent local anesthetic injection in dental practice in which the conventional technique is generally applied. However, multiple studies reported that the failure rate of IANB is high, whereupon our study aimed to assess the modified and conventional IANB techniques, concerning the success rate. Methods: A split-mouth single-blind randomized clinical trial study was conducted on 42 patients (84 cases) as paired analyzing, between 18 to 55 years-old, who needed bilateral IANB for posterior mandibular teeth extraction. To apply the modified technique, the barrel of the syringe was located in the corner of the mouth; while mouth is open wide and the needle-penetrated mucosa exactly lateral (anterior) to the pterygomandibular fold (PMF). The needlepoint was 5–15 mm above the occlusal plane (OP) according to the digital panoramic radiography and parallel to OP. The outcomes were analyzed using the Cochran-Mantel-Haenszel test. Results: The success rates were 97.6% in the modified IANB and 83.3% in the conventional technique, evaluating in the first 10 minutes. Conclusion: The clinician can operate IANB by modified technique with fewer anatomical landmarks, clear injection points and the higher success rate upon which the performance will be easy by the beginners. Trial registration IRCT20150924024167N2, on 07.03.2020, was retrospectively registered.