Faculty of Dentistry, University of Toronto, 124 Edward St., Toronto, Ontario, M5G 1G6, Canada.
J Am Dent Assoc. 2011 Sep;142 Suppl 3:8S-12S. doi: 10.14219/jada.archive.2011.0341.
and Overview. The limited success rate of the standard inferior alveolar nerve block (IANB) has led to the development of alternative approaches for providing mandibular anesthesia. Two techniques, the Gow-Gates mandibular nerve block and the Akinosi-Vazirani closed-mouth mandibular nerve block, are reliable alternatives to the traditional IANB. The Gow-Gates technique requires the patient's mouth to be open wide, and the dentist aims to administer local anesthetic just anterior to the neck of the condyle in proximity to the mandibular branch of the trigeminal nerve after its exit from the foramen ovale. The Akinosi-Vazirani technique requires the patient's mouth to be closed, and the dentist aims to fill the pterygomandibular space with local anesthetic.
Both techniques are indicated for any type of dentistry performed in the mandibular arch, but they are particularly advantageous when the patient has a history of standard IANB failure owing to anatomical variability or accessory innervation.
Having the skill to perform these alternative anesthetic techniques increases dentists' ability to provide successful local anesthesia consistently for all procedures in mandibular teeth.
概述。标准下牙槽神经阻滞（IANB）的成功率有限，导致人们开发了替代方法来提供下颌麻醉。两种技术，即 Gow-Gates 下颌神经阻滞和 Akinosi-Vazirani 闭口下颌神经阻滞，是传统 IANB 的可靠替代方法。Gow-Gates 技术要求患者的嘴张大，牙医的目标是在髁突颈前，即三叉神经下颌支离开卵圆孔后，将局部麻醉剂注射到附近。Akinosi-Vazirani 技术要求患者闭口，牙医的目标是将局部麻醉剂填充到翼下颌间隙中。
这两种技术都适用于下颌弓中进行的任何类型的牙科治疗，但对于由于解剖结构变异或副神经支配而导致标准 IANB 失败的患者，它们尤其有利。
掌握这些替代麻醉技术可以提高牙医为下颌牙齿的所有手术提供成功局部麻醉的能力。
