BACKGROUND: The Halstead inferior alveolar nerve block (IANB) is the standard local anesthetic method for mandibular dental procedures, but it can fail due to anatomic variations. A modified mylohyoid anesthesia (MMA) block can be used as a supplemental injection technique for the surrounding tissues. Therefore, this study included patients undergoing mandibular molar surgery and aimed to compare outcomes following a modified mylohyoid nerve block with 4% articaine with epinephrine and dexamethasone, 4% articaine with epinephrine, and 2% lidocaine with epinephrine.

MATERIAL AND METHODS: Sixty patients were equally allocated into 3 groups (n=20). Group 1 received 4% articaine with epinephrine plus dexamethasone via modified mylohyoid anesthesia (MMA). Group 2 received MMA with 4% articaine and epinephrine alone. Group 3 (control) received 2% lidocaine with epinephrine using Halstead’s inferior alveolar nerve block. Pain intensity was assessed using a visual analog scale (VAS). Secondary outcomes included quality of anesthesia score (QAS) and duration of anesthesia (DOA).

RESULTS: Groups were comparable in age (P=0.958). Median VAS scores were 3.5, 5.5, and 8 mm for Groups 1, 2, and 3, respectively, with no significant differences (P=0.232). Median QAS was 2 in all groups (P=0.168). Mean DOA was 189.2, 216.5, and 219 min, respectively.

CONCLUSIONS: MMA demonstrated clinical outcomes comparable to the conventional inferior alveolar nerve block, although no statistically significant differences were observed among groups.

Keywords: Mandible, Dexamethasone, Anesthesia, Dental