Reliable profound mandibular block anesthesia is questionable when depositing the anesthetic solution at the lingula.
Complications can occur and the needle may impact a number of important anatomical structures by deep penetration.
The Gow-Gates technique for mandibular anesthesia obviates these problems. The Gow-Gates mandibular nerve block is a true mandibular block, since it anesthetizes almost the entire mandibular division of the trigeminal nerve (mandibular nerve or V3).
This nerve is a short main trunk formed where a smaller anterior trunk meets a larger posterior trunk in the infratemporal fossa before it passes through the foramen ovale of the sphenoid bone. Thus, the nerves anesthetized with a Gow-Gates mandibular nerve block are the inferior alveolar, mental, incisive, lingual, mylohyoid, auriculotemporal, and buccal (long) nerves in about 75% of patients.