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Clinical Oral Investigations

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01-04-2021 | Foreign Body Aspiration | Original Article

Evaluation of different mandibular blocks for the removal of lower third molars: a meta-analysis of randomised clinical trials

Authors: Carolina-Noemi Cavallini, Jorge Toledano-Serrabona, Cosme Gay-Escoda

Published in: Clinical Oral Investigations | Issue 4/2021

Abstract

Objectives

To describe the efficacy and number of side effects for the Gow-Gates mandibular block (GGMB) and Vazirani-Akinosi mandibular block (VAMB) compared to inferior alveolar nerve block (IANB) in patients requiring lower third molar (L3M) extraction.

Materials and methods

A systematic search was performed in three electronic databases and complemented with a manual search. The inclusion criteria were randomised clinical trials in healthy patients who underwent at least one L3M extraction. Screening and article selection were carried out by two independent reviewers. After data extraction, a meta-analysis was performed for the success rate, number of positive aspirations, and onset time outcomes.

Results

Six randomised clinical trials were included out of the 367 potentially eligible papers. No significant differences were found in terms of success rate using GGMB (risk ratio [RR] 1.04; 95% confidence interval [CI] 0.92 to 1.18; P = 0.48) nor VAMB (RR 0.96; 95% CI 0.86 to 1.06; P = 0.41). The VAMB group exhibited a lower number of positive aspirations than the IANB group (RR 0.08; 95% CI 0.01 to 0.55; P = 0.01), but there was no statistically significant difference between the GGMB and IANB groups (RR 1.06; 95% CI 0.13 to 8.78; P = 0.96). The delayed onset was even longer in GGMB (mean difference [MD] 3.32 min; 95% CI 1.98 to 4.66; P < 0.001) and VAMB (MD 0.90 min; 95% CI 0.37 to 1.43; P = 0.0001) than IANB.

Conclusions

GGMB and VAMB seem to be effective and safe anaesthetic techniques for the removal of L3M, but these blocks exhibited a more delayed onset time than IANB.

Clinical relevance

GGMB and VAMB are safe and effective anaesthetic techniques for the removal of L3M. However, IANB can still be considered the first option since GGMB and VAMB exhibited more delayed onset times and variable buccal nerve anaesthesia.

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Title: Evaluation of different mandibular blocks for the removal of lower third molars: a meta-analysis of randomised clinical trials
Authors: Carolina-Noemi Cavallini
Jorge Toledano-Serrabona
Cosme Gay-Escoda
Publication date: 01-04-2021
Publisher: Springer Berlin Heidelberg
Keywords: Foreign Body Aspiration
Foreign Body Aspiration
Aspiration
Nerve Block
Published in: Clinical Oral Investigations / Issue 4/2021
Print ISSN: 1432-6981
Electronic ISSN: 1436-3771
DOI: https://doi.org/10.1007/s00784-020-03525-9

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Evaluation of different mandibular blocks for the removal of lower third molars: a meta-analysis of randomised clinical trials

Abstract

Objectives

Materials and methods

Results

Conclusions

Clinical relevance

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Objectives

Materials and methods

Results

Conclusions

Clinical relevance

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