Optimizing Inferior Alveolar Nerve Block: An Interdisciplinary Approach between Dentistry and Anesthesiology
Abstract
Background: The Inferior Alveolar Nerve Block (IANB) is a fundamental regional anesthesia technique in dentistry, essential for procedures on the mandibular teeth and soft tissues. Despite its widespread use, it has a reported failure rate of 15-20%, often due to anatomical complexity and technical inaccuracies in locating the mandibular foramen.
Aim: This article aims to synthesize the principles of IANB administration, advocating for an interdisciplinary approach between dentistry and anesthesiology to optimize its success, enhance patient safety, and manage complications effectively.
Methods: A comprehensive review of the IANB technique is presented, covering the relevant anatomy of the mandibular nerve and foramen, indications, contraindications, and necessary equipment. The analysis details the conventional injection technique, evidence-based modifications (e.g., Thangavelu, Gow-Gates), and the role of technology like Computer-Controlled Local Anesthetic Delivery (CCLAD) systems. Potential local, neurological, and systemic complications and their management are also examined.
Results: Mastery of the IANB requires a deep understanding of anatomical landmarks and their variations. Techniques guided by consistent bony landmarks, such as the internal oblique ridge, may improve success rates. Furthermore, a coordinated, interprofessional team approach—involving dentists, physicians, nurses, and pharmacists—is critical for pre-procedural risk assessment, safe administration, and managing emergencies like local anesthetic systemic toxicity (LAST).
Conclusion: The IANB remains a cornerstone of dental practice. Its optimization hinges on anatomical expertise, technical precision, and a collaborative healthcare model that prioritizes patient-specific care and safety.
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Authors
Copyright (c) 2025 Ershad Hussein Ali Alnemi, Mohammed Ahmed Asiri, Mohammed Mashraqi, Abdulrahman Samir Khateiri, Ruwayda Hamed Yahya Sughayyir , Abdulaziz Abdullah Alahmari, Wahaj Awadh Matar Alsaadi, May Ayed Alanazi, Hanan Salah Almutairi, Abdallh Badr Obaid Almutiri, Ershad Hussein Ali Alnemi, Eid Mohammad Ahmed Hadi, Haifa Suliman Aljohani , Noor Naif Alaswad Alazmi
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