Journal of Maxillofacial and Oral Surgery

, Volume 17, Issue 4, pp 570–575 | Cite as

Comparison of Efficacy of Halstead, Vazirani Akinosi and Gow Gates Techniques for Mandibular Anesthesia

  • B. Sarat Ravi KiranEmail author
  • Vinay M. Kashyap
  • Uday Kiran Uppada
  • Prabhat Tiwari
  • Ashank Mishra
  • Akanksha Sachdeva
Original Article



Traditionally, the “Halstead block” has been widely used to provide anesthesia in mandibular teeth. Two other techniques, the Gow Gates mandibular nerve block and the Akinosi Vazirani closed-mouth mandibular nerve block, are reliable alternatives to the conventional inferior alveolar nerve block. The purpose of this study is to evaluate the onset of anesthesia, anesthetic success and incidence of positive aspiration during administration of local anesthetic solution using the Halstead, Vazirani Akinosi and Gow Gates techniques.

Materials and method

The study involves 210 subjects, divided into three different groups of 70 subjects each receiving Gow Gates, Vazirani Akinosi and conventional inferior alveolar nerve blocks. The onset of anesthesia, positive aspiration and anesthetic success was evaluated.


In Vazirani Akinosi technique group, patients showed highest anesthetic success of 95.71%; there was a significant difference seen between the Gow Gates and Vazirani Akinosi techniques (p = 0.0241*). The mean value of the onset of anesthesia in Gow Gates technique showed the longest 343.71 ± 153.20 s, in Halstead technique it was 177.43 ± 59.94 s, and in Vazirani Akinosi technique it was 192.86 ± 61.20 s. There was a significant difference seen between Gow Gates and Vazirani Akinosi techniques (p = 0.0001*) and Gow Gates and inferior alveolar nerve block techniques (p = 0.0001*).


The Vazirani Akinosi technique was found to be significantly better than the other two techniques with respect to both onset and success of anesthesia. Positive aspirations were slightly higher in the conventional IANB technique compared to the other two, but did not reach statistical significance.


Inferior alveolar nerve block Vazirani Akinosi Gow Gates technique Pterygomandibular space 


Compliance with Ethical Standards

Conflict of interests

Authors declare that they have no conflict of interest.


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Copyright information

© The Association of Oral and Maxillofacial Surgeons of India 2018

Authors and Affiliations

  • B. Sarat Ravi Kiran
    • 1
    Email author
  • Vinay M. Kashyap
    • 2
  • Uday Kiran Uppada
    • 1
  • Prabhat Tiwari
    • 1
  • Ashank Mishra
    • 3
  • Akanksha Sachdeva
    • 4
  1. 1.Department of Oral and Maxillofacial SurgerySri Sai College of Dental SurgeryVikarabadIndia
  2. 2.Department of Oral and Maxillofacial SurgeryOxford Dental CollegeBangaloreIndia
  3. 3.Department of PeriodonticsSri Sai College of Dental SurgeryVikarabadIndia
  4. 4.Ridgetop Dental ClinicBangaloreIndia

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