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Kevin Jae Choi, Marisa Ann Ryan, Tracy Cheng, David Powers
Craniomaxillofacial injuries can be complex, requiring a multidisciplinary approach. The primary survey is always the first step in trauma management prior to proceeding with further evaluation and treatment. A 26-year-old man presented with a penetrating nail gun injury through the oral and nasal cavities. He did not present in extremis but required elective endotracheal intubation for intraoperative assessment and treatment. Airway management was enhanced by the use of lingual nerve and inferior alveolar nerve blocks via the Vazirani-Akinosi technique to maintain spontaneous respiration while the tongue was distracted from the palate...
June 2017: Craniomaxillofacial Trauma & Reconstruction
Fanyuan Yu, Yao Xiao, Hanghang Liu, Fanzi Wu, Feng Lou, Dian Chen, Mingru Bai, Dingming Huang, Chenglin Wang, Ling Ye
A patient's pain during mandibular third molar extraction often creates problems for a dental surgeon and can also cause immense patient discomfort, such as decreased quality of life, serious complications, or even danger to the patients' lives. Effective pain management is therefore of great importance. Conventional block anesthesia method often fails to control such pain completely during an operation. Therefore, two available alternatives, Gow-Gates (G-G) and Vazirani-Akinosi (V-A) methods, have been developed...
January 20, 2017: Scientific Reports
Gaurav Jain, Ghanshyam Yadav, Anil Prasad Singh, Yashpal Singh, Dinesh Kumar Singh
BACKGROUND: Mandibular nerve block reverses the trismus caused by pain and muscle spasm, thereby allowing for selection of a safer intubation technique. AIMS: As ultrasonographic imaging has added newer dimensions to clinical anesthesia practice, we utilized this tool in performing mandibular nerve block and evaluated its efficacy in segregating trismus patients on etiological basis, to predict safer anesthetic induction. SETTINGS AND DESIGN: Prospective, randomized controlled, outcome assessor blinded trial...
May 2016: Anesthesia, Essays and Researches
Maryam AlHindi, Bayan Rashed, Noura AlOtaibi
OBJECTIVES: To report the failure rate of inferior alveolar nerve block (IANB) among dental students and interns, causes of failure, investigate awareness of different IANB techniques, and to report IANB-associated complications.   METHODS: A 3-page questionnaire containing 13 questions was distributed to a random sample of 350 third to fifth years students and interns at the College of Dentistry, King Saud University, Riyadh, Saudi Arabia on January 2011. It included demographic questions (age, gender, and academic level) and questions on IANB failure frequency and reasons, actions taken to overcome the failure, and awareness of different anesthetic techniques, supplementary techniques, and complications...
January 2016: Saudi Medical Journal
Vivian Click, Melissa Drum, Al Reader, John Nusstein, Mike Beck
INTRODUCTION: Few studies have evaluated the effectiveness of the Gow-Gates and Vazirani-Akinosi techniques in patients presenting with symptomatic irreversible pulpitis. Therefore, the purpose of this prospective, randomized study was to evaluate the anesthetic efficacy of the Gow-Gates and Vazirani-Akinosi techniques using 3.6 mL 2% lidocaine with 1:100,000 epinephrine in mandibular posterior teeth in patients presenting with symptomatic irreversible pulpitis. METHODS: One hundred twenty-five emergency patients diagnosed with symptomatic irreversible pulpitis randomly received either a Gow-Gates or Vazirani-Akinosi injection using 3...
January 2015: Journal of Endodontics
Erika Cvetko
The inferior alveolar nerve block is one of the most common techniques for delivering dental anesthesia. Its success depends on placing the needle tip in close proximity to the mandibular foramen (MF). In certain cases, however, this nerve block fails, even when performed by the most experienced clinician. Anatomical variability may be one source of local anesthetic failure and includes bone and nerve variations. A case is presented of a bilateral anomalous high position of the MF, identified from the panoramic radiograph...
August 2014: Surgical and Radiologic Anatomy: SRA
U Mgbeokwere
BACKGROUND: Profound local anaesthesia is a desired clinicalcondition in surgical treatment of lesions in the oral cavity. This is because patients' cooperation is better assured with a pain-free field of operation. In dentistry this is usually achieved by either infiltration or block anaesthesia. The inferior alveolar nerve (IAN) block is the main block anaesthesia employed in dentistry, particularly for mandibular procedures. Different techniques of achieving this block anaesthesia have been described...
January 2012: Nigerian Journal of Medicine: Journal of the National Association of Resident Doctors of Nigeria
C Bacci, M L Mariuzzi, C Ghirotto, S Fusetti
Breakage of a local anesthetic needle in dentistry is a rare but potentially serious event. Here we describe a case of breakage of a hypodermic needle during administration of local anesthesia with a Vazirani-Akinosi mandibular nerve block in a 5-year-old uncooperative patient under moderate sedation with midazolam. The needle was localized using a fluoroscopy device and then removed under general anaesthesia. The postoperative course was unremarkable, without any neurological or vascular deficits.
July 2012: Minerva Stomatologica
O M Gbotolorun, A C O Olojede, M Afolabi-Bello, G T Arotiba
BACKGROUND: The conventional inferior alveolar nerve block (IANB) has been used for mandibular anaesthesia for many years. It is associated with a number of complications including failure of anaesthesia. Alternative techniques were therefore developed for the mandibular anaesthesia. OBJECTIVE: This study is to evaluate the knowledge and practice of alternatives to the conventional inferior alveolar nerve block (IANB) amongst dentist in government owned hospitals in Lagos, Nigeria...
October 2010: Nigerian Quarterly Journal of Hospital Medicine
Paul A Moore, Michael A Cuddy, Matthew R Cooke, Chester J Sokolowski
BACKGROUND: and Overview. The provision of mandibular anesthesia traditionally has relied on nerve block anesthetic techniques such as the Halsted, the Gow-Gates and the Akinosi-Vazirani methods. The authors present two alternative techniques to provide local anesthesia in mandibular teeth: the periodontal ligament (PDL) injection and the intraosseous (IO) injection. The authors also present indications for and complications associated with these techniques. CONCLUSIONS: The PDL injection and the IO injection are effective anesthetic techniques for managing nerve block failures and for providing localized anesthesia in the mandible...
September 2011: Journal of the American Dental Association
Daniel A Haas
BACKGROUND: and Overview. The limited success rate of the standard inferior alveolar nerve block (IANB) has led to the development of alternative approaches for providing mandibular anesthesia. Two techniques, the Gow-Gates mandibular nerve block and the Akinosi-Vazirani closed-mouth mandibular nerve block, are reliable alternatives to the traditional IANB. The Gow-Gates technique requires the patient's mouth to be open wide, and the dentist aims to administer local anesthetic just anterior to the neck of the condyle in proximity to the mandibular branch of the trigeminal nerve after its exit from the foramen ovale...
September 2011: Journal of the American Dental Association
Jacob B Rifkind
Although needle breakage is a rare complication of local anesthetic administration in the oral cavity, it can result in a high degree of morbidity and legal action against the practitioner. This is a case report of a 48-year-old woman who was referred for removal of a broken needle following a Vazirani-Akinosi nerve block. Management involved removal of the needle in a surgical setting with fluoroscopic guidance and 2-point reference.
2011: Journal—Canadian Dental Association, Journal de L'Association Dentaire Canadienne
William C Forbes
In the case of the difficult-to-anesthetize patient, the inferior alveolar nerve can be particularly challenging In those patients, other approaches may be necessary to achieve profound anesthesia. This article presents techniques that may be used in those efforts. The clinician can change his target slightly, or increase the dosage of anesthetic. Accessory innervation by lingual and mylohyoid nerves sometimes needs to be addressed. Some standard alternative approaches are Gow-Gates and Varizani-Akinosi injections...
May 2010: Today's FDA: Official Monthly Journal of the Florida Dental Association
Vivek Aggarwal, Mamta Singla, Debipada Kabi
OBJECTIVE: Conventional inferior alveolar nerve block (IANB) has a poor success rate in inflamed pulps. Three alternative techniques of providing anesthesia to mandibular molars were evaluated and compared with conventional IANB. STUDY DESIGN: Ninety-seven adult volunteer subjects, actively experiencing pain, participated in this prospective, randomized, double-blinded study. Twenty-five patients received Gow-Gates mandibular conduction block anesthesia, 24 patients received "high" Vazirani-Akinosi inferior alveolar nerve block, 26 received only buccal-plus-lingual infiltrations, and 22 patients (control) received conventional IANB anesthesia...
February 2010: Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontics
Steven Goldberg, Al Reader, Melissa Drum, John Nusstein, Mike Beck
The purpose of this prospective, randomized study was to compare the degree of pulpal anesthesia obtained with the conventional inferior alveolar, the Gow-Gates, and the Vazirani-Akinosi techniques in vital, asymptomatic teeth. With a crossover design, 40 subjects received all 3 techniques in a random manner by using 3.6 mL of 2% lidocaine with 1:100,000 epinephrine at 3 separate appointments. An electric pulp tester was used to test for anesthesia in 3-minute cycles for 60 minutes of the first molars, first premolars, and lateral incisors...
November 2008: Journal of Endodontics
(no author information available yet)
The Editorial Board of the Journal of Endodontics has developed a literature-based study guide of topical areas related to endodontics. This study guide is intended to give the reader a focused review of the essential endodontic literature and does not cite all possible articles related to each topic. Although citing all articles would be comprehensive, it would defeat the idea of a study guide. This section will cover pain theories and dentin hypersensitivity, referred pain, oral pain not of dental origin, barodontalgia, local anesthetics, long-acting local anesthetics, intrapulpal anesthesia, intraligamentary anesthesia, intraosseous anesthesia, inferior alveolar nerve block anesthesia, Gow-Gates anesthesia technique, Vazirani-Akinosi anesthesia technique, second-division block anesthesia technique, endodontic postoperative pain, effect of occlusal adjustment on endodontic pain, paresthesia associated with periradicular pathosis, analgesics, sedation, and endodontic flare-ups...
May 2008: Journal of Endodontics
Thomas M Johnson, Rachel Badovinac, Jeffry Shaefer
Surveys were sent to Harvard School of Dental Medicine students and graduates from the classes of 2000 through 2006 to determine their current primary means of achieving mandibular anesthesia. Orthodontists and orthodontic residents were excluded. All subjects received clinical training in the conventional inferior alveolar nerve block and two alternative techniques (the Akinosi mandibular block and the Gow-Gates mandibular block) during their predoctoral dental education. This study tests the hypothesis that students and graduates who received training in the conventional inferior alveolar nerve block, the Akinosi mandibular block, and the Gow-Gates mandibular block will report more frequent current utilization of alternatives to the conventional inferior alveolar nerve block than clinicians trained in the conventional technique only...
September 2007: Journal of Dental Education
A Mosadomi, O Akinosi
A case of grossly disfiguring ossifying fibroma of the left maxilla is presented. The lesion expanded the left maxilla, the left zygomatic bone and it filled the left maxillary antrum to the partial obstruction of the nares. The lesion was completely excised under general anesthesia. About a year post-operatively, patient was fitted with a denture obturator. Further cosmetic osteotomy contemplated on the zyomatic bone which was flayered out could not be carried out because the patient was lost to follow-up.
January 1976: Nigerian Medical Journal: Journal of the Nigeria Medical Association
William C Forbes
In the case of the difficult-to-anesthetize patient, the inferior alveolar nerve can be particularly challenging. In those patients, other approaches may be necessary to achieve profound anesthesia. This article presents techniques that may be utilized in those efforts. The clinician can change his target slightly, or increase the dosage of anesthetic. Accessory innervation by lingual and mylohyoid nerves sometimes needs to be addressed. Some standard alternative approaches are Gow-Gates and Varizani-Akinosi injections...
May 2005: Journal of the Michigan Dental Association
Shawn Jacobs, Daniel A Haas, John G Meechan, Sherry May
BACKGROUND: The authors conducted this study to compare the pain on injection of the three mandibular block techniques and to determine the effect that the delivery of nitrous oxide:oxygen, or N2O:O2, had on this pain. METHODS: Based on sample size calculation, the authors randomly assigned 60 subjects to receive either local anesthetic alone or local anesthetic with N2O:O2 titrated to effect. Each subject received two mandibular block injections bilaterally from three possible pairings: Gow-Gates/standard block, standard block/Vazirani-Akinosi or Gow-Gates/ Vazirani-Akinosi...
July 2003: Journal of the American Dental Association
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