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Published in: Oral and Maxillofacial Surgery 3/2008

01-09-2008 | Original Article

Design and development of a device for facilitation of Gow-Gates mandibular block and evaluation of its efficacy

Authors: Mohammad Zandi, Shabnam Seyedzadeh Sabounchi

Published in: Oral and Maxillofacial Surgery | Issue 3/2008

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Abstract

Introduction

The Gow-Gates technique is a useful alternative to the inferior alveolar nerve block whenever the latter fails to provide adequate anesthesia. The main disadvantage of this technique is that the incidence of unsuccessful anesthesia may be as high as that for the inferior alveolar nerve block until the administrator gains clinical experience with it.

Objectives

The aim of this study was to develop a device that facilitates the Gow-Gates technique and to increase its success rate even for administrators who are unfamiliar with this procedure.

Materials and methods

Ninety patients participated in our study. Forty-five patients received Gow-Gates mandibular block with device, and 45 patients received it without instrument (control group). Ninety 5th-year dental students who had no previous clinical experience with the Gow-Gates technique injected the patients.

Results and discussion

The success rate of anesthesia of inferior alveolar nerve, lingual nerve, buccal nerve, and auriculotemporal nerve were 93.3%, 93.3%, 91.1%, and 91.1%, respectively, in the study group and 68.9%, 68.2%, 68.9%, and 68.2%, respectively, in the control group.

Conclusion

We concluded that our device facilitates the Gow-Gates technique and increases its success rate irrespective of the gender of the patient, the side of the mandible being injected, and the experience of the administrator who uses the instrument.
Literature
1.
go back to reference Bolding SL, Hutchins B (1987) Accessory innervation of the mandibular dentition in the cat. J Dent Res 66:157, Abstract 402 Bolding SL, Hutchins B (1987) Accessory innervation of the mandibular dentition in the cat. J Dent Res 66:157, Abstract 402
2.
go back to reference Brodsky CD, Dower JS Jr (2001) Middle ear problems after a Gow-Gates injection. J Am Dent Assoc 132:1420–1423PubMed Brodsky CD, Dower JS Jr (2001) Middle ear problems after a Gow-Gates injection. J Am Dent Assoc 132:1420–1423PubMed
3.
go back to reference Childers M, Reader A, Nist R, Beck M, Meyers WJ (1996) The anesthetic efficacy of the periodontal ligament injection after an inferior alveolar nerve block. J Endod 22:317–320PubMedCrossRef Childers M, Reader A, Nist R, Beck M, Meyers WJ (1996) The anesthetic efficacy of the periodontal ligament injection after an inferior alveolar nerve block. J Endod 22:317–320PubMedCrossRef
4.
go back to reference Clark S, Reader A, Beck M, Meyers WJ (1999) Anesthetic efficacy of the myelohyoid nerve block and combination inferior alveolar nerve block/myelohyoid nerve block. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 87:557–563PubMedCrossRef Clark S, Reader A, Beck M, Meyers WJ (1999) Anesthetic efficacy of the myelohyoid nerve block and combination inferior alveolar nerve block/myelohyoid nerve block. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 87:557–563PubMedCrossRef
5.
go back to reference Dunbar D, Reader A, Nist R, Beck M, Meyers WJ (1996) Anesthetic efficacy of the intraosseous injection after an inferior alveolar nerve block. J Endod 22:481–486PubMedCrossRef Dunbar D, Reader A, Nist R, Beck M, Meyers WJ (1996) Anesthetic efficacy of the intraosseous injection after an inferior alveolar nerve block. J Endod 22:481–486PubMedCrossRef
6.
go back to reference Fish LR, McIntire DN, Johnson L (1989) Temporary paralysis of cranial nerves III, IV and VI after a Gow-Gates injection. J Am Dent Assoc 119:127–130PubMed Fish LR, McIntire DN, Johnson L (1989) Temporary paralysis of cranial nerves III, IV and VI after a Gow-Gates injection. J Am Dent Assoc 119:127–130PubMed
7.
go back to reference Frommer J, Mele FA, Monroe CW (1972) The possible role of the myelohyoid nerve in mandibular posterior tooth sensation. J Am Dent Assoc 85:113–117PubMed Frommer J, Mele FA, Monroe CW (1972) The possible role of the myelohyoid nerve in mandibular posterior tooth sensation. J Am Dent Assoc 85:113–117PubMed
8.
go back to reference Gow-Gates G, Watson JE (1989) Gow-Gates mandibular block—applied anatomy and histology. Anesth Prog 36:192–200 Gow-Gates G, Watson JE (1989) Gow-Gates mandibular block—applied anatomy and histology. Anesth Prog 36:192–200
9.
go back to reference Gow-Gates G (1973) Mandibular conduction anesthesia: a new technique using extraoral landmarks. Oral Surg Oral Med Oral Pathol 36:321–377PubMedCrossRef Gow-Gates G (1973) Mandibular conduction anesthesia: a new technique using extraoral landmarks. Oral Surg Oral Med Oral Pathol 36:321–377PubMedCrossRef
10.
go back to reference Gustainis JF, Peterson LJ (1981) An alternative method of mandibular nerve block. J Am Dent Assoc 103:33–36PubMed Gustainis JF, Peterson LJ (1981) An alternative method of mandibular nerve block. J Am Dent Assoc 103:33–36PubMed
11.
go back to reference Heasman PA, Beynon ADG (1987) Quantitative and spectrum analysis of human myelohyoid nerve. J Anat 151:45–49PubMed Heasman PA, Beynon ADG (1987) Quantitative and spectrum analysis of human myelohyoid nerve. J Anat 151:45–49PubMed
12.
go back to reference Jacobs S, Haas DA, Meechan JG, May S (2003) Injection pain: comparison of three mandibular blocktechniques and modulation by nitrous oxide:oxygen. J Am Dent Assoc 134:869–876PubMed Jacobs S, Haas DA, Meechan JG, May S (2003) Injection pain: comparison of three mandibular blocktechniques and modulation by nitrous oxide:oxygen. J Am Dent Assoc 134:869–876PubMed
13.
go back to reference Jofre J, Munzenmayer C (1998) Design and preliminary evaluation of an extraoral Gow-Gates guiding device. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 85:661–664PubMedCrossRef Jofre J, Munzenmayer C (1998) Design and preliminary evaluation of an extraoral Gow-Gates guiding device. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 85:661–664PubMedCrossRef
14.
go back to reference Kafalias MC, Gow-Gates G, Saliba GJ (1987) The Gow-Gates technique for mandibular block anesthesia. Anesth Prog 34:142–149PubMed Kafalias MC, Gow-Gates G, Saliba GJ (1987) The Gow-Gates technique for mandibular block anesthesia. Anesth Prog 34:142–149PubMed
15.
go back to reference Kaufman E, Weinstein P, Milligram P (1984) Difficulties in achieving local anesthesia. J Am Dent Assoc 108:205–208PubMed Kaufman E, Weinstein P, Milligram P (1984) Difficulties in achieving local anesthesia. J Am Dent Assoc 108:205–208PubMed
16.
go back to reference Levy P (1981) An assessment of the Gow-Gates mandibular block for third molar surgery. J Am Dent Assoc 103:37–41PubMed Levy P (1981) An assessment of the Gow-Gates mandibular block for third molar surgery. J Am Dent Assoc 103:37–41PubMed
17.
go back to reference Malamed SF (1981) The Gow-Gates mandibular block; evaluation after 4,275 cases. Oral Surg Oral Med Oral Pathol 51:463–467PubMedCrossRef Malamed SF (1981) The Gow-Gates mandibular block; evaluation after 4,275 cases. Oral Surg Oral Med Oral Pathol 51:463–467PubMedCrossRef
18.
go back to reference Malamed SF (2004) Techniques of mandibular anesthesia. Handbook of local anesthesia. Mosby, St Louis, pp 227–253 Malamed SF (2004) Techniques of mandibular anesthesia. Handbook of local anesthesia. Mosby, St Louis, pp 227–253
19.
go back to reference Munzenmayer C, Tima M (1989) La tecnica de Gow-Gates, una alternative para la tercera rama del Trigemino. Anuario Hospital las Higueras 6:96–97 Munzenmayer C, Tima M (1989) La tecnica de Gow-Gates, una alternative para la tercera rama del Trigemino. Anuario Hospital las Higueras 6:96–97
20.
go back to reference Nist R, Reader A, Beck M, Meyers WJ (1992) An evaluation of the incisive nerve block and combination inferior alveolar and incisive nerve block in mandibular anesthesia. J Endod 18:455–459PubMedCrossRef Nist R, Reader A, Beck M, Meyers WJ (1992) An evaluation of the incisive nerve block and combination inferior alveolar and incisive nerve block in mandibular anesthesia. J Endod 18:455–459PubMedCrossRef
21.
go back to reference Novitsky J (1938) Sensory nerves and anesthesia of the teeth and jaws. Mod Dent 5:5–10 Novitsky J (1938) Sensory nerves and anesthesia of the teeth and jaws. Mod Dent 5:5–10
22.
go back to reference Potocnik I, Bajrovic F (1999) Failure of inferior alveolar nerve block in endodontics. Endod dent Traumatol 15:247–251PubMedCrossRef Potocnik I, Bajrovic F (1999) Failure of inferior alveolar nerve block in endodontics. Endod dent Traumatol 15:247–251PubMedCrossRef
23.
go back to reference Reitz J, Reader A, Nist R, Beck M, Meyers WJ (1998) Anesthetic efficacy of the intraosseous injection of 0.9 ml of 2% lidocaine (1:100,000 epinephrine) to augment an inferior alveolar nerve block. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 86:516–523PubMedCrossRef Reitz J, Reader A, Nist R, Beck M, Meyers WJ (1998) Anesthetic efficacy of the intraosseous injection of 0.9 ml of 2% lidocaine (1:100,000 epinephrine) to augment an inferior alveolar nerve block. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 86:516–523PubMedCrossRef
24.
go back to reference Sicher H (1946) The anatomy of the mandibular anesthesia. J Am Dent Assoc 33:1541–1557 Sicher H (1946) The anatomy of the mandibular anesthesia. J Am Dent Assoc 33:1541–1557
25.
go back to reference Sillanpaa M, Vuori V, Lehtinen R (1988) The myelohyoid nerve and mandibular anesthesia. Int J Oral Maxillofac Surg 17:206–207PubMedCrossRef Sillanpaa M, Vuori V, Lehtinen R (1988) The myelohyoid nerve and mandibular anesthesia. Int J Oral Maxillofac Surg 17:206–207PubMedCrossRef
26.
go back to reference Sisk AL (1985) Evaluation of the Gow-Gates mandibular block for oral surgery. Anesth Prog 32:143–146PubMed Sisk AL (1985) Evaluation of the Gow-Gates mandibular block for oral surgery. Anesth Prog 32:143–146PubMed
27.
go back to reference Takasugi Y, Furuya H, Moriya K, Okamoto Y (2000) Clinical evaluation of inferior alveolar nerve block by injection into the pterygomandibular space anterior to the mandibular foramen. Anesth Prog 47:125–129PubMed Takasugi Y, Furuya H, Moriya K, Okamoto Y (2000) Clinical evaluation of inferior alveolar nerve block by injection into the pterygomandibular space anterior to the mandibular foramen. Anesth Prog 47:125–129PubMed
28.
go back to reference Watson JE, Gow-Gates G (1992) Incidence of positive aspiration in the Gow-Gates mandibular block. Anesthesia and Pain Control in Dentistry 1:73–76PubMed Watson JE, Gow-Gates G (1992) Incidence of positive aspiration in the Gow-Gates mandibular block. Anesthesia and Pain Control in Dentistry 1:73–76PubMed
29.
go back to reference Wilson S, Johns PI, Fuller PM (1984) Accessory innervation of mandibular anterior teeth in cats: a horseradish peroxidase study. Brain Res 298:392–396PubMedCrossRef Wilson S, Johns PI, Fuller PM (1984) Accessory innervation of mandibular anterior teeth in cats: a horseradish peroxidase study. Brain Res 298:392–396PubMedCrossRef
30.
go back to reference Wilson S, Johns PI, Fuller PM (1984) The inferior alveolar and myelohyoid nerves: an anatomic study and relationship to local anesthesia of the anterior mandibular teeth. J Am Dent Assoc 108:350–352PubMed Wilson S, Johns PI, Fuller PM (1984) The inferior alveolar and myelohyoid nerves: an anatomic study and relationship to local anesthesia of the anterior mandibular teeth. J Am Dent Assoc 108:350–352PubMed
31.
go back to reference Yamada A, Jastak JT (1981) Clinical evaluation of the Gow-Gates block in children. Anesth Prog 28:106–109PubMed Yamada A, Jastak JT (1981) Clinical evaluation of the Gow-Gates block in children. Anesth Prog 28:106–109PubMed
Metadata
Title
Design and development of a device for facilitation of Gow-Gates mandibular block and evaluation of its efficacy
Authors
Mohammad Zandi
Shabnam Seyedzadeh Sabounchi
Publication date
01-09-2008
Publisher
Springer-Verlag
Published in
Oral and Maxillofacial Surgery / Issue 3/2008
Print ISSN: 1865-1550
Electronic ISSN: 1865-1569
DOI
https://doi.org/10.1007/s10006-008-0126-4

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