Temporary paralysis of cranial nerves III, IV, and VI after a Gow-Gates injection

Fish, L; McIntire, David N.; Johnson, Leigh

doi:10.14219/jada.archive.1989.0137

Cited by 29 publications

(12 citation statements)

References 6 publications

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“…13 Isolated cases of temporary paralysis of cranial nerves III, IV, and VI following the Gow-Gates mandibular block have been reported. 14,15 This type of complication may result from omission of careful aspiration and failure to inject the anesthetic solution within the target area. 14 According to Malamed, the solution should not be deposited unless bone (the lateral aspect of the neck of the condyle) is sounded with the needle when administering a Gow-Gates block.…”

mentioning

confidence: 99%

Teaching Alternatives to the Standard Inferior Alveolar Nerve Block in Dental Education: Outcomes in Clinical Practice

Johnson

Badovinac

Shaefer

2007

Journal of Dental Education

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Surveys were sent to Harvard School of Dental Medicine students and graduates from the classes of 2000 through 2006 to determine their current primary means of achieving mandibular anesthesia. Orthodontists and orthodontic residents were excluded. All subjects received clinical training in the conventional inferior alveolar nerve block and two alternative techniques (the Akinosi mandibular block and the Gow-Gates mandibular block) during their predoctoral dental education. This study tests the hypothesis that students and graduates who received training in the conventional inferior alveolar nerve block, the Akinosi mandibular block, and the Gow-Gates mandibular block will report more frequent current utilization of alternatives to the conventional inferior alveolar nerve block than clinicians trained in the conventional technique only. At the 95 percent confidence level, we estimated that between 3.7 percent and 16.1 percent (mean=8.5 percent) of clinicians trained in using the Gow-Gates technique use this injection technique primarily, and between 35.4 percent and 56.3 percent (mean=47.5 percent) of those trained in the Gow-Gates method never use this technique. At the same confidence level, between 0.0 percent and 3.8 percent (mean=0.0 percent) of clinicians trained in using the Akinosi technique use this injection clinical technique primarily, and between 62.2 percent and 81.1 percent (mean=72.3 percent) of those trained in the Akinosi method never use this technique. No control group that was completely untrained in the Gow-Gates or Akinosi techniques was available for comparison. However, we presume that zero percent of clinicians who have not been trained in a given technique will use the technique in clinical practice.

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mentioning

confidence: 99%

Teaching Alternatives to the Standard Inferior Alveolar Nerve Block in Dental Education: Outcomes in Clinical Practice

Johnson

Badovinac

Shaefer

2007

Journal of Dental Education

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“…Careful aspiration and direction of the needle to an area with fewer large-bore blood vessels such as the lateral aspect of the condyle are recommended to avoid this complication. 18…”

Section: Transient Paralysis Of Combinations Of Cranial Nervesmentioning

confidence: 99%

Neurological Complications of Local Anaesthetics in Dentistry

Crean

Powis²

1999

Dent Update

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Neurological complications following the administration of a local anaesthetic can be alarming. By reading reports of such incidents, dentists who find themselves in similar situations will be able to reassure their patients and act accordingly. The authors have reviewed the literature for those neurological complications that have been reported and offer an explanation of their aetiology. Examples of complications covered are facial nerve palsy, transient amaurosis, post-injection paraesthesia, Horner's syndrome, transient paralysis of combined cranial nerves III, IV and VI, sudden unilateral deafness and abducens nerve palsy. A thorough knowledge of the relevant anatomy pertinent to the various injections used in dental surgery is essential and is highlighted in the text.

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“…The patient’s opinion about the dental treatment is closely related to the local anesthesia experience and the proper use of local anesthesia techniques and pain management are indispensable for successful dental treatment. Although pain control is accomplished successfully in most cases, some anesthesia techniques like mandibular block are accompanied by some drawbacks including difficulty in achieving anesthesia because of anatomic variations; 1 deep and invasive needle penetration; 2,3 paresthesia; 1 muscle trismus; 4 paralysis; 5 transportation of oral microbial flora to anatomic spaces; 6 delayed onset of anesthesia; 7,8 hematom formation; 9 high incidence of positive aspiration; 9 undesired soft and/or hard tissue anesthesia with possible patient-induced injury, 7,10 and difficulty in hemostasis in patients with bleeding disorders. 10,21,24 The inferior alveolar nerve block (IANB) is the most commonly used injection technique for achieving local anesthesia for mandibular restorative and surgical procedures.…”

Section: Introductionmentioning

confidence: 99%

Application of crestal anesthesia for treatment of class I caries in posterior mandibular teeth

Talesh

Kahnamouii²

2011

Dental Research

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Temporary paralysis of cranial nerves III, IV, and VI after a Gow-Gates injection

Cited by 29 publications

References 6 publications

Teaching Alternatives to the Standard Inferior Alveolar Nerve Block in Dental Education: Outcomes in Clinical Practice

Teaching Alternatives to the Standard Inferior Alveolar Nerve Block in Dental Education: Outcomes in Clinical Practice

Neurological Complications of Local Anaesthetics in Dentistry

Application of crestal anesthesia for treatment of class I caries in posterior mandibular teeth

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