An evaluation of the incisive nerve block and combination inferior alveolar and incisive nerve blocks in mandibular anesthesia.

The purpose of this study was to measure the degree of anesthesia obtained with the incisive nerve block, the inferior alveolar nerve block and a combination of both injections in mandibular teeth. Using a repeated measures design, 40 subjects randomly received an incisive nerve block, a conventional inferior alveolar nerve block, or a combination inferior alveolar nerve block plus an incisive nerve block using either lidocaine or saline (control), at four successive appointments. The mandibular teeth and contralateral canine (+/- controls) were blindly tested with an Analytic Technology pulp tester at 4-min cycles for 60 min. An 80 reading indicated complete pulpal anesthesia. The incisive nerve block alone did not result in successful pulpal anesthesia in the central, lateral, first, and second molars. It was successful in the first and second premolars but the duration was approximately 30 min. The combination inferior alveolar nerve block plus incisive nerve block was successful in the first and second premolars, and enhanced anesthesia for the laterals and first molars.