Clinical comparison of pulpal anesthesia resulting from two mandibular block anesthetic techniques: conventional and Gow - Gates

One of the current ptoblems 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. Inferior dental anesthesia via conevenional and Gow - Gates techniques were evaluated using onset of anesthesia, pain severity duriny injection, aspiration test, pulpal anesthesia (via ice test, cavity test and pain during entrance into pulp chamber) and pinprick test (inferior alveolar, long buccal nerves).58 patients requiring root canal rteatment 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. No significant diffetences 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 = 0.001). Although the aspiration test did not show a sigcificant difference, but the lack of positive aspitation case in Gow - Gates technique, in conparison with %10.7 in conventional technique seemed to be important. No significant difference in pulpal anesthesia between two techniques was shown,% 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 anesthesized more in Gow - Gates tenchnique (%75) as compared with conventional one (%42.9), which was significantly different (p=0.01), but other branches (inferior alveolar and lingual nerves) were anesthesized equally in both applied techniques. On average, patients acquired lip and tongue numbness in 1.42 and 3.27 minutes, respectively in minutes was required in conventional method but more than 7 minutes was required in Gow-Gates technique. (p<0.001). 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.