A Gow-Gates technique is indicated for use in quadrant dentistry in cases where soft-tissue anesthesia from the most distal molar to midline is needed, and where conventional inferior alveolar nerve block (IA block) is unsuccessful.
Its success rate is greater than 95%—higher than that of IA block—and in many cases only one injection is required for mandibular anesthesia.
Its lower positive aspiration rate also is an advantage, being 2% instead of the 10–15% associated with IA block.
► See also: DENTAL ANESTHESIA: Simple and safe posterior superior alveolar nerve block
The technique is named after Dr. George Gow-Gates, who championed it as a successful alternative to the IA block. 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.
°By Margaret J. Fehrenbach, RDH, MS