ANATOMICAL VARIATIONS – CRITICAL BLOCKERS TO INFERIOR ALVEOLAR NERVE ANAESTHESIA
Author: YADAV CHAKRAVARTHY, JOSEPH PAUL, JANANI JAYAKUMAR
Category: Clinical Sciences
Abstract:
Pain management is both a challenge and an opportunity for the endodontist. Successful management of pain emergencies is a strong component of clinical excellence. Unlike in maxillary teeth where supra periosteal anaesthesia is effective anaesthetising the adult mandibular teeth for endodontic treatment by inferior alveolar nerve block has not always been successful especially in patients with irreversible pulpitis. Previous studies show a success rate of only 19-56% of inferior alveolar nerve block in cases of irreversible pulpitis. This local anaesthesia failure can occur in a substantial proportion of endodontic pain patients. Several studies have cited reasons for failure of inferior alveolar nerve anaesthesia in healthy or inflamed pulps. The reasons include pulpitis, concentration and volume of anaesthetic solution, patient anxiety, anatomical differences (such as accessory innervations, bifid inferior alveolar nerve, anatomic position of mandibular canal, ) etc. This article highlights the importance the clinician should give in understanding the role of various anatomical variations that may influence the success of an inferior alveolar nerve block.
