COMPARISON OF EFFECTIVENESS OF INFERIOR ALVEOLAR NERVE BLOCK AND GOW GATES TECHNIQUE IN MANDIBULAR MOLAR TEETH WITH IRREVERSIBLE PULPITIS

Authors

  • Abeera Faraz Aabbasi Department of Operative Dentistry, Rawal Institute of Health Sciences Islamabad-Pakistan
  • Rizwan Qureshi Department of Operative Dentistry, Rawal Institute of Health Sciences, Islamabad-Pakistan
  • Shazia Mehmood Department of Operative Dentistry, Rawal Institute of Health Sciences Islamabad-Pakistan
  • Ghazala Dayyan Department of Operative Dentistry, Rawal Institute of Health Sciences Islamabad-Pakistan
  • Muhammad Adnan Rashid Department of Community Medicine, Ayub Medical College, Abbottabad-Pakistan
  • Saqib Sarfaraz Department of Operative Dentistry, Rawal Institute of Health Sciences Islamabad-Pakistan

Keywords:

Irreversible Pulpitis, Inferior Alveolar Nerve Block Technique, Gow Gates Technique.

Abstract

Background: Local anaesthetics are the most important and most utilized agents in the dental profession today. Achieving effective pain control holds a prime importance for any dental procedure. The most commonly employed technique to achieve effective anaesthesia in mandibular molar teeth with irreversible pulpitis is Inferior Alveolar Nerve Block. However, in some cases this technique may not prove successful and the clinician may have to resort to alternative methods of achieving effective anaesthesia. Our study aims to compare two different techniques employed for anaesthesia, i.e., the conventional Inferior Alveolar Nerve Block and the alternative Gow Gates Technique in achieving effective anaesthesia in mandibular molar teeth. Methods: We conducted a randomized controlled trial in the Operative Dentistry department of Rawal Institute of Health Sciences Islamabad. We selected 102 patients presenting with irreversible pulpitis in mandibular posterior teeth. The selected patients were randomly allocated into two groups. In each group, the subjects were given 1.8 m.L of lidocaine (2%) with epinephrine 1: 100,000 (Medicainer Inj, HuonCo., Ltd, Korea) by using anaesthetic cartridges that had aspirating syringe. Results: Subjects in Group A were given inferior alveolar nerve block while those in Group B received Gow-Gates nerve block. The patients were then asked to rate their pre-operative and intra-operative pain on a visual analogue scale (VAS). Data analysis was done using SPSS-22, followed by comparison of efficacy between the two groups. anaesthesia was found to be effective among 36 subjects (69%) of Group-A and 44 subjects of (84%) Group-B. Hence, we concluded that the success rate of Gow-Gates technique and Inferior alveolar nerve block anaesthetic technique differs significantly. Conclusion: Gow-Gates technique can be considered as an applicable alternative to the conventional Inferior alveolar nerve block technique while providing anaesthesia to patients presenting with irreversible pulpitis in mandibular posterior teeth, having a higher anaesthetic success of (84%) when compared with the conventional Inferior alveolar nerve block (69%).

References

Almasri MA, Karpe T, Mogla S, Pendyala SK, Keshini MP, Hussain AB, et al. Efficacy of Vazirani Akinosi and Gow Gates technique in inferior alveolar nerve block:A comparative study. Int J Health Sci 2022;6(S1):1257–62.

Bhat P, Chanu HT, Radhakrishna S, Ashok Kumar KR, Marimallappa TR, Ravikumar R. Comparison Of Clinical Efficacy of classical Inferior Alveolar Nerve Block and Vazirani Akinosi Technique in bilateral mandiblar premolar teeth removal: A Split-mouth randomized study. J Maxillofac Oral Surg 2022;21(2):191–202.

smaeili H, Malekzadeh M, Esmaeili D, Nikeghbal F. Dental anxiety and the effectiveness of local anaesthesia. Braz J Oral Sci 2020;19:e208127.

Wu Y, Yao X, Jiang Y, He X, Shao X, Du J, et al. Pain aversion and anxiety like behavior occur at different times during the course of chronic inflammatory pain in rats. J Pain Res 2017;10:2585–93.

Shah FA, Jan IU, Ali A, Afridi RU, Zain M, Haider S. Comparison of anasthetic efficacy of Inferior Alveolar Nerve Block and Vazirani akinosi Techniques in patients with irreversible pulpitis. Pak Oral Dental J 2019;39(3):301–3.

Nagendrababu V, Ahmed HM, Pulikkotil SJ, Veettil SK, Dharmarajan L, Setzer FC. anaesthetic efficacy of Gow-Gates, VaziraniAkinosi and Mental Incisive Nerve Blocks for treatment of symptomatic irreversible pulpitis: A systematic review and meta-analysis with trial sequential analysis. J Endod 2019;45(10):1175–83.

Mundodi AU, Patil RS, Wagdargi SS, Chakravarthy C. Comparison of anaesthetic efficacy of Inferior Alveolar, Gow Gates and VaziraniAkinosi Technique in dentoalveolar surgery. Natl J Integr Res Med 2021;12(2):33–8.

Goldberg S, Reader A, Drum M, Nusstein J, Beck M. Comparison of anaesthetic efficacy of conventional inferior alvelor, Gow Gates and Vazirani Akinosi techniques. J Endod 2008;34(11):1306–11.

Hung PC, Chang HH, Yang PJ, Kuo YS, Lan WH, Lin CP. Comparison of Gow Gates mandibular block and inferior alveolar nerve block using a standardized protocol. J Formos Med Assoc 2006;105(2):139–46.

Ravi Kiran BS, Kashyap VM, Uppada UK, Tiwari P, Mishra A, Sachdeva A. Comparison of efficacy of Halstead, VaziraniAkinosi and Gow Gates Technique for mandibular anaesthesia. J Maxillofac Oral Surg 2018;17(12):570–5.

Haas DA. Alternative mandibular nerve block techniques: A review of the Gow Gates and AkinosiVazirani closed mouth mandibular nerve block techniques. J Am Dent Assoc 2011;142(3):S8–12.

Aggarwal V, Singla M, Kabi D. Comparative evaluation of Gow-Gates mandibular conduction anaesthesia, Vazirani Akinosi technique, buccal plus lingual infiltrations and conventional inferior alveolar nerve anaesthesia in patients with irreversible pulpitis. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2010;109(2):303–8.

Shairaz Sadiq M, Ahmed S, Qazi SR. Dental practitioner’s choice of local anaesthesia technique for mandibular molar anaesthesia. Pak Oral Dental J 2017;37(2):227–30.

Click V, Drum M, Reader A, Nusstein J, Beck M. Evaluation of Gow-Gates and Vazirani-Akinosi techniques in patients with symptomatic irreversible pulpitis: A prospective randomized study. J Endod 2015;41(1):16–21.

Basit A, Mahmood S, Naeem M, Khan S. Mandibular local anaesthetic failures: Are we taking the challenge seriously? Pak Oral Dent J 2017;37(4):551–6.

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Published

2024-06-30