Comparative evaluation of efficacy of Halstead technique, Clark and Holmes technique, Gow Gates technique, and Sargenti technique for mandibular anesthesia

Natl J Maxillofac Surg. 2023 Sep-Dec;14(3):466-470. doi: 10.4103/njms.njms_157_22. Epub 2023 Nov 10.

Abstract

Aim: This study aimed to evaluate the inferior alveolar nerve block, that is, the Halstead technique, Clark and Holmes technique, Gow Gates technique, and Sargenti technique, for mandibular anesthesia.

Methodology: This prospective, double-blinded, in-vivo study was conducted amongst 100 patients, requiring mandibular anesthesia. These patients were divided into four groups. Parameters assessed were time required for appearance of subjective and objective symptoms and signs, positive aspiration, need for supplementary anesthesia, and ease of administration.

Results: The means for subjective symptoms for the four techniques, that is, Halstead technique, Clark and Holmes technique, Gow Gates technique, and Sargenti technique, were 78.44, 120.76, 176.6, and 203.08, respectively. The means for objectives symptoms for the four techniques, that is, Halstead technique, Clark and Holmes technique, Gow Gates technique, and Sargenti technique, were 110.6, 269.8, 287.48, and 154.08, respectively. Halstead technique had statistically significant (P < 0.05) faster objective signs than all the other techniques. Supplementary block if required was noted for all four techniques.

Conclusion: The Clark and Holmes technique showed maximum complications, while Gow Gates technique was most difficult to administer. The Angelo Sargenti technique gave good results, same as standard Halstead technique.

Keywords: Clark and Holmes technique; Gow Gates technique; Halstead technique; Sargenti technique; inferior alveolar nerve block.