Case ReportMiddle ear problems after a Gow-Gates injection
Section snippets
CASE REPORT
During a local anesthetic practice exercise at the University of the Pacific School of Dentistry, San Francisco, a healthy 22-year-old male dental student was administered a Gow-Gates injection that resulted in complete anesthesia of the inferior alveolar, lingual and auriculotemporal nerves. A classmate, carrying out the procedure under one-on-one supervision from a trained and experienced faculty dentist, had noted a positive aspiration on needle insertion and thus adjusted the needle until a
DISCUSSION
The deposition site for the Gow-Gates mandibular block is approximately 1 millimeter from the neck of the condyle, below the insertion of the lateral pterygoid muscle in a relatively avascular fatty area.15 There have been inconsistent reports on the frequency of positive aspirations with the Gow-Gates injection. In 1977, Gow-Gates and Watson16 reported a 1.6 percent incidence of positive aspiration with this injection, far lower than the 7.9 percent average in eight studies in which a total of
CONCLUSIONS
Whether one is an inexperienced novice or an accomplished practitioner, proper technique is a very important aspect of administering local anesthetic. Without proper technique, the clinician may inflict pain on patients and incur complications unnecessarily. Therefore, when performing the Gow-Gates technique, the clinician should be sure to orient the syringe properly before puncturing the mucosa.2 One of the keys to mastering this technique is the lateral angulation of the needle, which must
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2015, Journal of Oral and Maxillofacial SurgeryCitation Excerpt :The first is incomplete aspiration of the injection technique. One study has reported that the positive aspiration ratio of the inferior alveolar nerve block is only 7.9%.22 In addition, a needle can deviate out of the first injection point if the patient moves.
Ophthalmologic complications after intraoral local anesthesia: Case report and review of literature
2012, Oral Surgery, Oral Medicine, Oral Pathology and Oral RadiologyOcular Complications Associated with Local Anesthesia Administration in Dentistry
2010, Dental Clinics of North AmericaA Novel Approach to Intraoral Mandibular Nerve Anesthesia: Changing Reference Planes in the Gow-Gates Block Technique
2009, Journal of Oral and Maxillofacial SurgeryAvoiding complications in local anesthesia induction: Anatomical considerations
2003, Journal of the American Dental AssociationA stroke mimicker following inferior alveolar nerve block: a case report
2023, Journal of Oral Medicine and Oral Surgery
- 1
Mr. Brodsky is a Class of 2002 student at the University of the Pacific, School of Dentistry, San Francisco.
- 2
Dr. Dower is an associate professor, Restorative Dentistry, and the director, Local Anesthesia Curriculum, University of the Pacific School of Dentistry, 2155 Webster St., San Francisco, Calif. 94115-2333