The missed inferior alveolar block: a new look at an old problem.

A variation of a previously described technique to obtain mandibular block anesthesia is presented. This technique varies from those previously described in that is uses palpable anatomic landmarks, both extra- and intraoral, to orient the placement of the needle. This technique relies on several readily observed landmarks and the integration of these landmarks. Because palpable landmarks are used, consistent results can be easily obtained even in patients who present with a wide variety of anatomical variances which otherwise make this injection technique difficult and prone to failure.