Evaluation of Different Mandibular Blocks for the Removal of Lower Third Molars: a Meta-analysis of Randomised Clinical Trials

Overview

Journal Clin Oral Investig

Specialty Dentistry

Date 2020 Aug 26

PMID 32839834

Authors

Carolina-Noemi Cavallini

Jorge Toledano-Serrabona

Cosme Gay-Escoda

Affiliations

Soon will be listed here.

Abstract

Objectives: To describe the efficacy and number of side effects for the Gow-Gates mandibular block (GGMB) and Vazirani-Akinosi mandibular block (VAMB) compared to inferior alveolar nerve block (IANB) in patients requiring lower third molar (L3M) extraction.

Materials And Methods: A systematic search was performed in three electronic databases and complemented with a manual search. The inclusion criteria were randomised clinical trials in healthy patients who underwent at least one L3M extraction. Screening and article selection were carried out by two independent reviewers. After data extraction, a meta-analysis was performed for the success rate, number of positive aspirations, and onset time outcomes.

Results: Six randomised clinical trials were included out of the 367 potentially eligible papers. No significant differences were found in terms of success rate using GGMB (risk ratio [RR] 1.04; 95% confidence interval [CI] 0.92 to 1.18; P = 0.48) nor VAMB (RR 0.96; 95% CI 0.86 to 1.06; P = 0.41). The VAMB group exhibited a lower number of positive aspirations than the IANB group (RR 0.08; 95% CI 0.01 to 0.55; P = 0.01), but there was no statistically significant difference between the GGMB and IANB groups (RR 1.06; 95% CI 0.13 to 8.78; P = 0.96). The delayed onset was even longer in GGMB (mean difference [MD] 3.32 min; 95% CI 1.98 to 4.66; P < 0.001) and VAMB (MD 0.90 min; 95% CI 0.37 to 1.43; P = 0.0001) than IANB.

Conclusions: GGMB and VAMB seem to be effective and safe anaesthetic techniques for the removal of L3M, but these blocks exhibited a more delayed onset time than IANB.

Clinical Relevance: GGMB and VAMB are safe and effective anaesthetic techniques for the removal of L3M. However, IANB can still be considered the first option since GGMB and VAMB exhibited more delayed onset times and variable buccal nerve anaesthesia.

Citing Articles

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PMID: 39901265 PMC: 11789294. DOI: 10.1186/s13005-025-00481-1.

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