You Tae Min, Kim Kee-Deog, Huh Jisun, Woo Eun-Jung, Park Wonse
Department of Advanced General Dentistry, College of Dentistry, Dankook University, Cheonan, Korea.
Department of Advanced General Dentistry, College of Dentistry, Yonsei University, Seoul, Korea.
J Dent Anesth Pain Med. 2015 Sep;15(3):113-119. doi: 10.17245/jdapm.2015.15.3.113. Epub 2015 Sep 30.
The inferior alveolar nerve block (IANB) is the most common anesthetic techniques in dentistry; however, its success rate is low. The purpose of this study was to determine the correlation between IANB failure and mandibular skeletal characteristics.
In total, 693 cases of lower third molar extraction (n = 575 patients) were examined in this study. The ratio of the condylar and coronoid distances from the mandibular foramen (condyle-coronoid ratio [CC ratio]) was calculated, and the mandibular skeleton was then classified as normal, retrognathic, or prognathic. The correlation between IANB failure and sex, treatment side, and the CC ratio was assessed.
The IANB failure rates for normal, retrognathic, and prognathic mandibles were 7.3%, 14.5%, and 9.5%, respectively, and the failure rate was highest among those with a CC ratio < 0.8 (severe retrognathic mandible). The failure rate was significantly higher in the retrognathic group than in normal group (P = 0.019), and there was no statistically significant difference between the other two groups.
IANB failure could be attributable, in part, to the skeletal characteristics of the mandible. In addition, the failure rate was found to be significantly higher in the retrognathic group.
下牙槽神经阻滞（IANB）是牙科最常用的麻醉技术；然而，其成功率较低。本研究的目的是确定IANB失败与下颌骨骨骼特征之间的相关性。
本研究共检查了693例下颌第三磨牙拔除病例（n = 575例患者）。计算下颌孔与髁突和喙突的距离之比（髁突 - 喙突比率[CC比率]），然后将下颌骨骨骼分为正常、后缩或前突。评估IANB失败与性别、治疗侧和CC比率之间的相关性。
正常、后缩和前突下颌骨的IANB失败率分别为7.3%、14.5%和9.5%，CC比率<0.8（严重后缩下颌骨）的患者失败率最高。后缩组的失败率显著高于正常组（P = 0.019），其他两组之间无统计学显著差异。
IANB失败可能部分归因于下颌骨的骨骼特征。此外，发现后缩组的失败率显著更高。
