Modified Mylohyoid Nerve Anesthesia/Block With 4% Articaine and Dexamethasone Versus Halstead's IANB With 2% Lidocaine in Mandibular Molar Surgery: A Comparative Analysis of Efficacy and Safety Outcomes.

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.