Inferior alveolar nerve block and third-molar agenesis: a retrospective clinical study

J Am Dent Assoc. 2013 Apr;144(4):389-95. doi: 10.14219/jada.archive.2013.0132.

Abstract

Background: Children often receive inferior alveolar nerve blocks (IANBs) when their third molars are just beginning to develop. The location of the third-molar follicle is close to where the needle penetrates during an IANB. The authors examined the possible association between IANBs and missing third molars.

Methods: The authors examined 439 potential sites of third-molar development for evidence of third-molar follicles on panoramic radiographs of randomly selected children 7 years and older. The authors conducted a statistical comparison of the incidence of missing third-molar follicles in a control group of children who had no history of receiving IANBs with children in a test group who had a definitive history of receiving IANBs by means of generalized estimating equations.

Results: The authors found a statistically significant greater incidence of missing third-molar follicles in mandibular quadrants that had a definitive history of receiving IANBs compared with mandibular quadrants that had no history of receiving IANB.

Conclusion: IANBs administered to young children when the third-molar tooth bud is immature may stop third-molar development. Owing to the significant clinical implications, further research is needed to verify these results.

Practical implications: Dentists inadvertently may be stopping the development of third molars when administering IANBs to children.

Publication types

  • Comparative Study

MeSH terms

  • Age Factors
  • Anodontia / epidemiology*
  • Boston / epidemiology
  • Child
  • Cohort Studies
  • Dental Sac / diagnostic imaging
  • Dental Sac / physiology
  • Female
  • Humans
  • Incidence
  • Male
  • Mandibular Nerve*
  • Molar, Third / abnormalities*
  • Molar, Third / diagnostic imaging
  • Needles / adverse effects
  • Nerve Block* / adverse effects
  • Nerve Block* / instrumentation
  • Odontogenesis / physiology
  • Radiography, Panoramic
  • Retrospective Studies
  • Sex Factors