Nanjappa Madan1, Kateel Shashidhara Kamath2, A L Gopinath1, A Yashvanth3, Nagaraj Vaibhav4, G Praveen5. 1. Department of Oral and Maxillofacial Surgery, V. S. Dental College and Hospital, Bangalore, India. 2. Department of Oral and Maxillofacial Surgery, Sri Hasanamba Dental College and Hospital, Hassan, India. 3. Department of Oral and Maxillofacial Surgery, Daswani Dental College and Hospital, Kota, India. 4. Department of Oral and Maxillofacial Surgery, Sri Rajiv Gandhi Dental College, Bangalore, India. 5. Department of Public Health Dentistry, Sri Hasanamba Dental College and Hospital, Hassan, India.
Abstract
INTRODUCTION: Reliable profound mandibular block anesthesia is questionable when depositing the anesthetic solution at the lingula. The Gow-Gates technique is an useful alternative to the classical inferior alveolar nerve block and the incidence of unsuccessful anesthesia may be as high as classical technique. The aim of this study is to compare the clinical efficacy, degree of patient acceptability, advantages, disadvantages and limitations of the classical and Gow-Gates techniques for providing anesthesia in patients undergoing bilateral symmetrical surgical removal of impacted mandibular third molar under local anesthesia. MATERIAL AND METHODS: The split mouth design study was conducted on 100 patients aged between 20 to 40 years undergoing surgical removal of bilateral symmetrical impacted mandibular third molar performed by the same maxillofacial surgeon. 2 ml of 2 % lignocaine hydrochloride with 1:80,000 adrenaline was used as a standard local anesthetic solution in all the cases. By using four-digit numbers from a random number table, either Gow-Gates or classical inferior alveolar nerve block were randomly assigned to either left or right sides in each patient. The injections were administered by another surgeon who was blinded to the experiment. The patient was assessed for Pain experienced during injection, frequency of positive aspirations, Onset and duration of anesthesia and Nerves anesthetized. RESULTS: Results were statistically analyzed by Mann-Whitney and chi square test. A 'P' value of less than 0.05 was considered for statistical significance. Higher mean pain during injection was recorded in classical group, was found to be statistically significant. No significant association was observed between aspiration and the groups. Higher mean onset of anesthesia was recorded in Gow-gates group, was found to be statistically significant. Higher mean duration of anesthesia was recorded in Gow-gates group, was not statistically significant. Higher success rate was recorded in Gow-gates group and was statistically significant. CONCLUSION: If we ignore delayed onset of anesthesia of Gow gates technique, it is found to be more reliable, beneficial and have higher success rate than classical inferior alveolar nerve block technique.
RCT Entities:
INTRODUCTION: Reliable profound mandibular block anesthesia is questionable when depositing the anesthetic solution at the lingula. The Gow-Gates technique is an useful alternative to the classical inferior alveolar nerve block and the incidence of unsuccessful anesthesia may be as high as classical technique. The aim of this study is to compare the clinical efficacy, degree of patient acceptability, advantages, disadvantages and limitations of the classical and Gow-Gates techniques for providing anesthesia in patients undergoing bilateral symmetrical surgical removal of impacted mandibular third molar under local anesthesia. MATERIAL AND METHODS: The split mouth design study was conducted on 100 patients aged between 20 to 40 years undergoing surgical removal of bilateral symmetrical impacted mandibular third molar performed by the same maxillofacial surgeon. 2 ml of 2 % lignocaine hydrochloride with 1:80,000 adrenaline was used as a standard local anesthetic solution in all the cases. By using four-digit numbers from a random number table, either Gow-Gates or classical inferior alveolar nerve block were randomly assigned to either left or right sides in each patient. The injections were administered by another surgeon who was blinded to the experiment. The patient was assessed for Pain experienced during injection, frequency of positive aspirations, Onset and duration of anesthesia and Nerves anesthetized. RESULTS: Results were statistically analyzed by Mann-Whitney and chi square test. A 'P' value of less than 0.05 was considered for statistical significance. Higher mean pain during injection was recorded in classical group, was found to be statistically significant. No significant association was observed between aspiration and the groups. Higher mean onset of anesthesia was recorded in Gow-gates group, was found to be statistically significant. Higher mean duration of anesthesia was recorded in Gow-gates group, was not statistically significant. Higher success rate was recorded in Gow-gates group and was statistically significant. CONCLUSION: If we ignore delayed onset of anesthesia of Gow gates technique, it is found to be more reliable, beneficial and have higher success rate than classical inferior alveolar nerve block technique.
Authors: Preethi Bhat; Hijam Thoithoibi Chanu; Sathish Radhakrishna; K R Ashok Kumar; T R Marimallappa; R Ravikumar Journal: J Maxillofac Oral Surg Date: 2020-05-03