Anesthetic efficacy of the mylohyoid nerve block and combination inferior alveolar nerve block mylohyoid nerve block

Objective. The purpose of this study was to measure the degree of anesthesi a obtained with the mylohyoid nerve block and the combination mylohyoid ner ve block/conventional inferior alveolar nerve (IAN) block in mandibular tee th. Study design. With the use of a repeated-measures design, 30 subjects rando mly received each of 3 combinations of injections at 3 separate appointment s. The combinations were as follows: mylohyoid nerve block (1.8 mL of 2% li docaine with 1:100,000 epinephrine) + IAN block (3.6 mt of 2% lidocaine wit h 1:100,000 epinephrine); mock mylohyoid nerve block + IAN block (3.6 mt of 2% lidocaine with 1:100,000 epinephrine); mylohyoid nerve block (1.8 mt of 2% lidocaine with 1:100,000 epinephrine) + mock IAN block. The mylohyoid i njections were aided by the use of a peripheral nerve stimulator. Mandibula r anterior and posterior teeth were blindly tested with a pulp tester at 4- minute cycles for 60 minutes postinjection. Anesthesia was considered succe ssful when 2 consecutive 80 readings were obtained. Results. One hundred percent of the subjects hal lip numbness with the mylo hyoid nerve block + IAN block and mock mylohyoid nerve block + IAN block te chniques. For these 2 techniques, anesthetic success rates were higher in p osterior teeth (73% to 93%) than in anterior teeth (33% to 60%). There were no significant differences (P>.05) between the 2 techniques. The mylohyoid nerve block + mock IAN block technique resulted in a very low success rate (0% to 17%) and was significantly different (P<.05) from the mylohyoid ner ve block + IAN block technique. Conclusions. The results of this study suggest that the mylohyoid nerve blo ck does not by itself predictably provide pulpal anesthesia in mandibular t eeth and does not significantly enhance pulpal anesthesia when administered in combination with the IAN block.