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Randomized Controlled Trial
. 2021 Aug;25(8):4887-4893.
doi: 10.1007/s00784-021-03796-w. Epub 2021 Jan 19.

Do length and gauge of dental needle affect success in performing an inferior alveolar nerve block during extraction of adult mandibular molars? A prospective, randomized observer-blind, clinical trial

Essam Ahmed Al-Moraissi  1 , Abeer Mohammed Al-Selwi  2 , Elham Aziz Al-Zendani  2
Affiliations
Randomized Controlled Trial

Do length and gauge of dental needle affect success in performing an inferior alveolar nerve block during extraction of adult mandibular molars? A prospective, randomized observer-blind, clinical trial

Essam Ahmed Al-Moraissi et al. Clin Oral Investig. 2021 Aug.

Abstract

Objective: Association between length and gauge of dental needle and success rate and pain perception during an inferior alveolar nerve block (IANB) has not been investigated using a randomized clinical trial (RCT). This RCT aimed to compare the success rate of IANB and perceived pain using 27- or 30-gauge needles for the extraction of adult mandibular molars.

Material and method: A prospective RCT was conducted on two hundred and twelve adult patients requiring extraction of mandibular molars using standard methods as described by Malamed with 1.8 ml of 2% lidocaine with 1:80,000 adrenaline. One hundred six patients received IANB using 27-gauge needles (32 mm × 0.2 mm) and one hundred six patients received IANB using 30-gauge needles (25 mm × 0.15 mm). Predictor variables were 27-gauge and short and 30-gauge. Outcome variables were the success rate of IANB and pain perception during injection using a visual analogue scale.

Results: There was a highly significantly increase in the success of IANB using 27-gauge needle (95.28%) versus 30-gauge needle (41.51%) (P = 0.001). There was a significant increase in pain perception for patients who received IANB by shorter and thinner needle (30-gauge) when compared to the long and thicker needle (27-gauge).

Conclusion: This RCT demonstrated that 27-gauge needle seems to be associated with a higher success rate of IANB and lower pain perception during injection when compared to 30-gauge needle in the extraction of adult mandibular molars when compared to 30-gauge needles.

Clinical relevance: For adult patients, when thickness of soft tissue to be penetrated is essential to achieve bony contact, long or large gauge dental needle is preferred to get a higher success rate of IANB with less pain perception during injection.

Keywords: Inferior alveolar nerve block; Mandibular molars; Randomized clinical trial.

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