ABSTRACT
Background and aim: One of the current problems in endodontic treatment is the establishment of optimal anesthesia on mandible. In this clinical study, two approved mandibular block technique were compared in the establishment of pulpal anesthesia
Materials and Methods: Inferior dental anesthesia via conventional and Gow - Gates techniques were evaluated using onset of anesthesia, pain severity during injection, aspiration test, pulpal anesthesia [via ice test, cavity test and pain during entrance into pulp chamber] and pinprick test [inferior alveolar, lingual and long buccal nerves]. 58 patients requiring root canal treatment of mandibular molars were divided into two groups. They were given injections of 1.8 ml of % 2 lidocaine with adrenaline [1: 80,000]. Results were analyzed using Mamm - Whitney and t-student tests
Results: no significant differences were found between two techniques in ice test, cavity test, pain upon entrance to pulp chamber, pinprick test, aspiration test and injection better results about injection pain and aspiration test. Time required for lip and tongue anesthesia in conventional technique was less than Gow - Gates [P< 0.001] although buccal nerve was anesthetized more in Gow - Gates Technique [P=0.01]. Although the aspiration test did not show a significant difference, but the lack of positive aspiration case in Gow - Gates technique, in comparison with % 10.7 in conventional technique seemed to be important. No significant difference in pulpal anesthesia between two techniques was shown, however, %57.1 of patients had pain during entrance to pulp chamber in conventional technique comparing to %39.2 in Gow - Gates technique. The buccal nerve was anesthetized more in Gow - Gates technique [%75] as compared with conventional one [%42.9], which was significantly different [p=0.01], but other branches [inferior alveolar and lingual nerves] were anesthetized equally in both applied techniques. On average, patients acquired lip and tongue numbness in 1.42 and 3.27 minutes, respectively in conventional method but more than 7 minutes was required in Gow-Gates technique [p <0.001]
Conclusion: Irrespective of the operator clinical experience, Gow-Gales technique appears to be more effective in pulpal anesthesia although more slowly yielded anesthesia, as compared with conventional method, is one of its disadvantages