Comparison of Clinical Efficacy of Classical Inferior Alveolar Nerve Block and Vazirani-Akinosi Technique in Bilateral Mandibular Premolar Teeth Removal: A Split-Mouth Randomized Study

J Maxillofac Oral Surg. 2022 Mar;21(1):191-202. doi: 10.1007/s12663-020-01374-3. Epub 2020 May 3.

Abstract

Purpose: To compare the clinical efficacy of classical inferior alveolar nerve block (CIANB) and Vazirani-Akinosi (VA) injection technique in patients indicated for bilateral mandibular premolar teeth extraction for orthodontic treatment.

Methods: This split-mouth comparative study was conducted on 20 patients randomly selected for bilateral extraction of mandibular premolar indicated for orthodontic treatment to receive CIANB and VA injection technique alternatively. The clinical parameters evaluated were pain during injection, onset of anesthesia, duration of anesthesia, quality of anesthesia, nerve anesthetized with single nerve block, need for re-injection and frequency of positive aspiration.

Results: No statistically significant differences were observed regarding the onset of anesthesia, duration of anesthesia, quality of anesthesia, nerves anesthetized with single nerve block and need for re-injection. However, pain experienced during injection was statistically significant and was lesser in VA technique than CIANB. Positive aspiration was not found in both the injection techniques.

Conclusion: VA technique showed a statistically significant difference in terms of less pain experienced during injection than CIANB. However, though not significant, VA technique was more clinically superior over the CIANB in terms of duration of anesthesia, quality of anesthesia and the need for re-injection. Also in this study, there were no complications associated with any of the injection techniques and the prevalence of positive aspiration was not found in both the techniques.