Dentaltown April 2018 - 96
1970s, Gow-Gates popularized a technique addressing
the auriculotemporal, lingual, inferior alveolar, buccal,
incisal and mylohyoid nerves all in one injection, with
a high percentage of success compared with traditional
techniques.8 Despite this evidence, the AI theory was
never accepted as the core explanation for anesthetic
failure.3
The AI-to-the-IAN theory supports that the incidents
of unsuccessful anesthesia may result from innervations
of the adult mandible arising from the cervical plexus
(CP) in addition to the auriculotemporal, buccal,
mental, mylohyoid, incisal and lingual nerves. This
theory, introduced by Nevin in 1922, had not been
universally accepted because of the lack of anatomical
evidence demonstrating that the CP nerve can extend
to the mandible.
On the basis of a systematic literature review, human
cadaver dissections and a randomized control trial clinical
study completed by our research group and independent
studies, results confirmed that the CP supplied AI to the
inferior border of the posterior mandible in 97 percent
of cases through the transverse cervical nerve (TCN)
and the great auricular nerve (GAN), which could be
responsible for anesthetic failures during root canal
procedures in the posterior adult mandible.3,5,9,10,11,12
Hence, to achieve pulpal anesthesia in the posterior
mandible, an accessory innervation anesthetic protocol
(AIAP) that anesthetizes all the accessory nerves must
be devised.5
In private practice, I have been utilizing the AIAP
for root canal procedures with considerable success. The
way "clinical success" has been measured is by having
practically no need of doing the intrapulpal technique.
The AIAP is:
* Safe. In my clinical experience administering
the AIAP on 300 cases average per year over
11 years, no accidents have been reported.
* Reliable. Easy to be administered every time
in every patient.
* Effective. Practically, an "intrapulpal-less"
practice.
dentaltown.com \\ APRIL 2018
95
http://www.dentaltown.com
Table of Contents for the Digital Edition of Dentaltown April 2018
Dentaltown April 2018 - Intro
Dentaltown April 2018 - Cover1
Dentaltown April 2018 - Cover2
Dentaltown April 2018 - 1
Dentaltown April 2018 - 2
Dentaltown April 2018 - 3
Dentaltown April 2018 - 4
Dentaltown April 2018 - 5
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Dentaltown April 2018 - Cover3
Dentaltown April 2018 - Cover4
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