Question

In which of the following clinical situations is the Vazirani-Akinosi technique most appropriately indicated?

• A. Extraction of multiple teeth across quadrants
• B. Limited mouth opening / Mouth opening is less than 4 cm
• C. Inadequate anesthesia with conventional inferior alveolar nerve block
• D. For maxillary molar extraction

Hint:

Vazirani-Akinosi = Closed-mouth mandibular blockUsed mainly for patients with trismus or limited mouth opening.

Answer 1

The Correct Option is B

Step 1: Understanding the Vazirani-Akinosi Technique.
The Vazirani-Akinosi technique is also known as the closed-mouth mandibular nerve blockIt is a modification of the inferior alveolar nerve block and is performed with the patient’s mouth in a closed position
Step 2: Primary Indication.
This technique is especially useful in patients with trismus or limited mouth openingWhen the interincisal distance is reduced (less than 4 cm), conventional inferior alveolar nerve block becomes difficult to administerThe closed-mouth approach allows effective anesthesia without requiring wide mouth opening
Step 3: Evaluation of Options.
(A) Extraction of multiple teeth across quadrants: This does not specifically require the Akinosi technique
(B) Limited mouth opening / Mouth opening is less than 4 cm: CorrectThis is the classic indication for the Vazirani-Akinosi technique
(C) Inadequate anesthesia with conventional inferior alveolar nerve block: Although it may sometimes be used as an alternative, the primary indication remains limited mouth opening
(D) For maxillary molar extraction: This technique is for mandibular anesthesia, not maxillary molars
Step 4: Conclusion.
Therefore, the Vazirani-Akinosi technique is most appropriately indicated in cases of limited mouth opening or trismus