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: inferior alveolar nerve block, Varizani-Akinosi, and the Gow-Gates technique. It is reasonable to use infiltration anesthesia in the region between the mandibular left and right canines to achieve complete anesthesia. The Gow-Gates technique, in comparison to other techniques, has the highest success rates in achieving successful anesthesia approximately 99% in Dr Gow-Gates' experienced hands. This block is very close to a true mandibular nerve block, because it provides sensory anesthesia to virtually the entire distribution of the mandibular trigeminal division

current case reports a transient incident of blurred, double vision (diplopia) following a Gow-Gates mandibular quadrant block injection. Management of the patient following such a localized complication is important for practicing clinicians to understand and to properly address. CASE PRESENTATION At the University of the Pacific, Arthur A. Dugoni School of Dentistry, students enter into agreement 17 and learn basic techniques in local anesthesia delivery in a 3 students to 1 faculty member ratio. The Gow-Gates mandibular quadrant block

) nerve block. Figure 8. Second division (V2) nerve block. Gow-Gates George A. E. Gow-Gates first published this technique in 1973 18 ( Figure 9 ). Significant advantages of the Gow-Gates technique over the IA nerve block include its higher success rate, its lower incidence of positive aspiration, and the absence of problems with accessory sensory innervation to the mandibular teeth. The Gow-Gates injection anesthetizes the inferior alveolar, lingual, auriculotemporal, buccal (75% of the

Anesthetic (scientific report), 55 Duggi V, see Sandeep V, 3 Elsheikhomer AM, see Peerbhay F, 122 Esaki K, see Tsukamoto M, 201 Fa BA, Preliminary Evidence Supports Modification of Retraction Technique to Prevent Needlestick Injuries (clinical technique), 192 Fa BA, Temporary Diplopia After Gow-Gates Injection: Case Report and Review (case report), 139 Fujisawa T, see Kamekura N, 91 Fukayama H, see Sasaki Y, 185 Fukuda K, see Maeno M, 116 Fukuda K, see Ohkushi K, 175 Ganzberg S

block techniques: a review of the Gow-Gates and Akinosi-Vazirani closed-mouth mandibular nerve block techniques . J Am Dent Assoc . 2011 ; 142 ( suppl 3 ): 8S – 12S . 11 Goldberg S , Reader A , Drum M , Nusstein J , Beck M. Comparison of the anesthetic

Gow-Gates nerve block, the closed mouth (Vazirani-Akinosi) mandibular injection, and intraligamentary injections. Dentistry now has seen the development of other alternative techniques, including intraosseous injection using various intraosseous delivery systems and the development of computer-controlled local anesthesia delivery systems. Other innovations in the use of currently marketed drugs and new drugs with local anesthetic activity are mentioned in the review article. Dr Yagiela commented on the newly developed topical anesthetic called eutectic

injection is an option, but the practitioner must also take into account that VAS pressure is slightly higher with the PDL injection when compared with the other 3 techniques. Low-pressure, slow-delivery appa-ratuses, such as computerized syringes, should be evaluated as a possible means to minimize this variable. Also, if needle gauge has a minimum effect on pain perception on injection, then larger-diameter needles may be tested as an alternative for pressure reduction with PDL injection. When multiple tooth procedures are required, the Gow-Gates 27 and Akinosi 28

recommendations . J Am Dent Assoc . 2009 ; 140 (12) : 1517 – 1522 . 8.  Fa BA, Speaker SR, Budenz AW. Temporary diplopia after Gow-Gates injection: case report and review . Anesth Prog . 2016 ; 63 (3) : 139 – 146 . 9

on the incidence of BBF exposure incidents associated with needles during injection. METHODS The retrieval of data received institutional review board exemption 10-41.5 from the institutional committee review board. Within the local anesthesia curriculum, dental students learn basic and advanced dental injection technique over the course of a 3-year curriculum. These injections include, but are not limited to, infiltrations, posterior superior alveolar block, inferior alveolar nerve block, anterior superior alveolar block, and Gow-Gates