Assessment of anesthetic efficacy of anesthe angulated needle approach, halsted and fischer 1-2-3 inferior alveolar nerve block technique for extraction of mandibular teeth- a randomized control trial

Abstract

ABSTRACT Title: Assessment of anesthetic efficacy of Angulated Needle Approach, Halsted and Fischer 1-2-3 inferior alveolar nerve block technique for extraction of mandibular teeth- a Randomized Control Trial Background: Local anesthesia is essential for pain control in dental surgery, with the inferior alveolar nerve block (IANB) being the standard technique for anesthetizing the mandibular teeth, gingivae, and lower lip. Despite its widespread use, conventional methods like Halsted's direct technique and Fischer's indirect technique often yield inconsistent success rates (reported failures ranging from 13% to 48%), even when performed by experienced clinicians, due to the challenges of precise anatomical targeting. To address these limitations, newer approaches such as needle angulation modifications and single-path, multi-depth injections have been developed to enhance precision and efficacy. This study evaluates the angulated needle technique as a potential improvement over traditional IANB methods, comparing its accuracy and anesthetic effectiveness both during and after mandibular tooth extractions. Aim: Assessment of anesthetic efficacy of Angulated Needle Approach, Halsted and Fischer 1-2-3 inferior alveolar nerve block technique for extraction of mandibular teeth Materials and Methods: Sample size of 91 participants using standard formula was calculated. Participants were allocated into 3 groups as group I: Halsted and group II: Fischer and Group III: Angulated. Quality of Anesthesia was measured using Sick's Scale and intra-op and post-op pain was calculated using Visual Analog Scale(VAS). The statistical test to be done for the following parameters were: Descriptive statistics, X