Comparison of Success Rate of Local Anaesthesia Between GOW Gates and Inferior Alveolar Nerve Block Anaesthetic Technique in Patients with Irreversible Pulpitis in Mandibular Molars
DOI:
https://doi.org/10.51253/pafmj.v76iSUPPL-3.6848Keywords:
Gow Gates technique, Irreversible pulpitis, Inferior alveolar nerve block technique, local anaesthesiaAbstract
Objective: To compare local anaesthesia success of in patients with irreversible pulpitis in mandibular molars by using Gow Gates and Inferior alveolar nerve block techniques.
Study Design: Quasi-experimental.
Place and Duration of the Study: Armed Forces Institute of Dentistry, Rawalpindi, Pakistan from Jun to Dec 2019.
Methodology: 240 patients were enrolled and their consent was acquired. Patients were categorized into Group-A (Gow Gates technique) and Group-B (Inferior Alveolar Nerve Block technique), containing 120 patients each. Using the non-probability consecutive sampling technique; Gow Gates and Inferior alveolar nerve block were defined. Patients in both groups were anaesthetized using local anaesthetic agent containing 2% lignocaine with 1:100,000 epinephrine and were scheduled for Root Canal Treatment. Patients were briefed to convey status of pain experienced during the procedure by raising their hand and also to rate the pain on visual analogue scale. Pain score of less than 3 was considered successful.
Results: Two hundred and forty patients were enrolled in the study, 120 in each group. The mean patient age in group A was 37.8±8.5 years and in group B was 37.8±9.0 years. There were 62 males (51.7%) in group-A, 63 males (52.2%) in group B and 58 (48.3%) females in group-A & 57 (47.5%) in group B. Success of treatment of anaesthesia in both groups was comparable (p=0.631). The mean pain score in group-A was 2.58±1.5 and in group B 2.63±1.5 (p=0.238).
Conclusion: The local anaesthesia success by using inferior alveolar nerve block technique and Gow Gates’s technique was comparable in ..;
Downloads
References
1. Burns LE, Kim J, Wu Y, Alzwaideh R, McGowan R, Sigurdsson A. Outcomes of primary root canal therapy: An updated systematic review of longitudinal clinical studies published between 2003 and 2020. Int Endod J 2022; 55(7): 714-731.
https://doi.org/10.1111/iej.13736
2. Gemmell A, Stone S, Edwards D. Investigating acute management of irreversible pulpitis: a survey of general dental practitioners in North East England. Br Dent J 2020; 228(7): 521-526. https://doi.org/10.1038/s41415-020-1419-8
3. Gupta A, Sahai A, Aggarwal V, Mehta N, Abraham D, Jala S et al. Anesthetic efficacy of primary and supplemental buccal/lingual infiltration in patients with irreversible pulpitis in human mandibular molars: a systematic review and meta-analysis. J Dent Anesth Pain Med 2021; 21(4): 283-309.
https://doi.org/10.17245/jdapm.2021.21.4.283
4. Grant R, Brown T, Young L, Lamont T. How can local anaesthesia be improved in the management of irreversible pulpitis?. Evid Based Dent 2021; 22(1): 26-27.
https://doi.org/10.1038/s41432-021-0151-9
5. Nilius M, Mueller C, Nilius MH, Haim D, Leonhardt H, Lauer G et al. Intraosseous anesthesia in symptomatic irreversible pulpitis: Impact of bone thickness on perception and duration of pain. J Dent Anesth Pain Med 2020; 20(6): 367-375.
https://doi.org/10.17245/jdapm.2020.20.6.367
6. Nagendrababu V, Abbott PV, Pulikkotil SJ, Veettil SK, Dummer PM. Comparing the anaesthetic efficacy of 1.8 mL and 3.6 mL of anaesthetic solution for inferior alveolar nerve blocks for teeth with irreversible pulpitis: a systematic review and meta‐analysis with trial sequential analysis. Int Endod J 2021; 54(3): 331-342.
https://doi.org/10.1111/iej.13428
7. Qian S, Meng Z, Zhang H, Li K, Zhang F, Zhang S, et al. Articaine Needle-Free Anesthesia Vs Conventional Anesthesia in Root Canal Treatment of Irreversible Pulpitis in Permanent Teeth: A Prospective Study on Anesthetic Efficacy and Effects on Pain. J Pain Res 2025; 31: 2115-2125.
https://doi.org/10.2147/JPR.S514944
8. Dias-Junior LC, Bezerra AP, Schuldt DP, Kuntze MM, de Luca Canto G, da-Fonseca Garcia L et al. Effectiveness of different anesthetic methods for mandibular posterior teeth with symptomatic irreversible pulpitis: a systematic review and meta-analysis. Clin Oral Invest 2021; 25(12): 6477-6500.
https://doi.org/10.1007/s00784-021-04145-7
9. Li X, Chen X, Wang Q, Gui Y, Huang F, Zhong D et al. Evaluation of the effectiveness of local anesthesia approaches for symptomatic irreversible pulpitis: a systematic review and meta-analysis. Front. Dent. Med 2026; 6: 1679706.
https://doi.org/10.3389/fdmed.2025.1679706
10. Aggarwal V, Singla M, Kabi D. Comparative evaluation of anesthetic efficacy of Gow-Gates mandibular conduction anesthesia, Vazirani-Akinosi technique, buccal-plus-lingual infiltrations, and conventional inferior alveolar nerve anesthesia in patients with irreversible pulpitis. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2010; 109(2): 303-308.
https://doi.org/10.1016/j.tripleo.2009.09.016
11. Montserrat-Bosch M, Figueiredo R, Nogueira-Magalhães P, Arnabat-Dominguez J, Valmaseda-Castellón E, et al. Efficacy and complications associated with a modified inferior alveolar nerve block technique. A randomized, triple-blind clinical trial. Med Oral Patol Oral Cir Bucal 2014; 19(4): e391-397.
http://doi.org/doi:10.4317/medoral.19554
12. Lee CR, Yang HJ. Alternative techniques for failure of conventional inferior alveolar nerve block. J Dent Anesth Pain Med 2019; 19(3): 125.
https://doi.org/10.17245/jdapm.2019.19.3.125
13. Subbiya A, Rajendran V, Anuradha B, Suresh SM. Failure of inferior alveolar nerve block and how to overcome it: a review. Eur J Mol Clin Med 2020; 7(5): 1266-1269.
14. Alsaegh MA, Azzawi AD, Marouf BK. The performance of inferior alveolar nerve block technique among undergraduate students. Eur J Dental Educ 2023; 27(4): 985-991.
https://doi.org/10.1111/eje.12890
15. De Geus JL, Da Costa JK, Wambier LM, Maran BM, Loguercio AD, Reis A et al. Different anesthetics on the efficacy of inferior alveolar nerve block in patients with irreversible pulpitis: a network systematic review and meta-analysis. J Am Dent Assoc 2020; 151(2): 87-97. https://doi.org/10.1016/j.adaj.2019.09.002
16. Jaju KK, Nasim I. Anaesthetic Efficacy Of Alternative Local Anaesthesia Techniques In Patients With Irreversible Pulpitis-A Systematic Review. Int J Dentistry Oral Sci 2021; 8(6): 2833-2840.
http://doi.org/10.19070/2377-8075-21000573
17. Thomas AM, Mangalath U, Abida R, Aslam S, Soman S, Nair RB et al. Comparative evaluation of classical inferior alveolar nerve block and gow-gates nerve block for surgical removal of mandibular third molar: a prospective study. J Pharm Bioallied Sc 2021; 13(Suppl 2): S1011-1014.
http://dx.doi.org/10.4103/jpbs.jpbs_279_21
18. Nagendrababu V, Ahmed HM, Pulikkotil SJ, Veettil SK, Dharmarajan L, Setzer FC et al. Anesthetic efficacy of Gow-Gates, Vazirani-Akinosi, and mental incisive nerve blocks for treatment of symptomatic irreversible pulpitis: A systematic review and meta-analysis with trial sequential analysis. J Endod 2019; 45(10): 1175-1183.
https://doi.org/10.1016/j.joen.2019.06.008
19. Rehman S, Channar KA, Memon W, Kumbhar AA, Bilgrami A, Javed F et al. Comparison Between Gow-Gates Mandibular Nerve Block Versus Inferior Alveolar Nerve Block in Extraction of Mandibular Third Molars: Gow-Gates Mandibular Nerve Block Versus Inferior Alveolar Nerve Block. Pak J Health Sci 2024: 52-56. https://doi.org/10.54393/pjhs.v5i07.1621
Downloads
Published
Issue
Section
License
Copyright (c) 2026 Afshan Bibi, Khurram Waheed, Waqar Ahmad Khan, Saqiba Yaseen, Asma Munir, Javed Iqbal Bangash
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
How to Cite
