{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,29]],"date-time":"2026-08-29T23:19:31Z","timestamp":1788045571643,"version":"build-2784847793"},"reference-count":63,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2015,4,10]],"date-time":"2015-04-10T00:00:00Z","timestamp":1428624000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Clinical Anatomy"],"published-print":{"date-parts":[[2015,7]]},"abstract":"<jats:p><jats:bold>U<\/jats:bold>nsuccessful anesthesia of the inferior alveolar nerve (IAN) may be due to supplementary innervations of mandibular molars from other branches, namely the cervical plexus (CP). The purpose of this prospective, randomized, double\u2010blind, controlled trial was to determine the effectiveness of an intraoral cervical plexus anesthetic technique (ICPAT) in mandibular molars with symptomatic irreversible pulpitis (SIR) when the IAN and lingual nerve (LN) blocks failed, and to provide a description of the technique. Forty patients diagnosed with SIR received IAN and LN block anesthesia prior to treatment. After clinical signs of anesthesia, patients were subjected to an electrical pulp test (EPT) at 2\u2010min cycles for 10 min post\u2010injection. The anesthesia was considered unsuccessful if there was a positive EPT response ten minutes following profound lip numbness. The experimental group (<jats:italic>n<\/jats:italic>\u2009=\u200920) were administered 2% Lidocaine with 1:100,000 epinephrine using the ICPAT. The control group (<jats:italic>n<\/jats:italic>\u2009=\u200920) were administered 0.9% sterile saline using the ICPAT. Success was defined as no response on two consecutive readings from an EPT. In the experimental group, 60% of subjects showed successful anesthesia, whereas none of the subjects in the control group had successful anesthesia. A multiple logistic regression analysis showed that the anesthesia success rate using the ICPAT method was significantly higher (<jats:italic>P<\/jats:italic>\u2009&lt;\u20090.05) than in the control group, irrespective of molar tooth type. The ICPAT method may be useful as a supplementary anesthetic technique for mandibular molars with SIR in subjects whom the IAN and LN blocks do not provide adequate anesthesia. Clin. Anat. 28:608\u2013613, 2015. \u00a9 2015 Wiley Periodicals, Inc.<\/jats:p>","DOI":"10.1002\/ca.22543","type":"journal-article","created":{"date-parts":[[2015,4,10]],"date-time":"2015-04-10T18:32:08Z","timestamp":1428690728000},"page":"608-613","source":"Crossref","is-referenced-by-count":11,"title":["Description and evaluation of an intraoral cervical plexus anesthetic technique"],"prefix":"10.1002","volume":"28","author":[{"given":"Daniel P.","family":"Bitner","sequence":"first","affiliation":[{"name":"Department of Endodontology Temple University Kornberg School of Dentistry Philadelphia Pennsylvania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel","family":"Uzbelger Feldman","sequence":"additional","affiliation":[{"name":"Department of Endodontology Temple University Kornberg School of Dentistry Philadelphia Pennsylvania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kevin","family":"Axx","sequence":"additional","affiliation":[{"name":"Department of Endodontology Temple University Kornberg School of Dentistry Philadelphia Pennsylvania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jasim M.","family":"Albandar","sequence":"additional","affiliation":[{"name":"Department of Periodontology and Oral Implantology, Director, Periodontal Diagnostics Research Laboratory Temple University Kornberg School of Dentistry Philadelphia Pennsylvania"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2015,4,10]]},"reference":[{"key":"e_1_2_6_2_1","first-page":"17","article-title":"Control of pain in operative dentistry","volume":"5","author":"Adams FR","year":"1938","journal-title":"Bull Dent Soc St Ny"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.joen.2009.04.012"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1563\/AAID-JOI-D-10-00037"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.joen.2012.10.012"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.joen.2006.09.006"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/0003-9969(93)90129-A"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1097\/00000539-199811000-00011"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.2307\/2529594"},{"key":"e_1_2_6_10_1","first-page":"25","article-title":"A clinical evaluation of the electric pulp tester as an indicator of local anesthesia","volume":"21","author":"Certosimo AJ","year":"1996","journal-title":"Oper Dent"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1177\/00220345800590041601"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1079-2104(99)70133-2"},{"key":"e_1_2_6_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/0030-4220(82)90209-2"},{"key":"e_1_2_6_14_1","first-page":"356","article-title":"The cervical plexus and its probable role in the oral operator's field","volume":"73","author":"Cook W","year":"1951","journal-title":"Dent Items"},{"key":"e_1_2_6_15_1","first-page":"167","article-title":"Clinical significance of the supplementary innervation of the mandibular teeth: A dissection study of the transverse cervical (cutaneous colli) nerve","volume":"19","author":"Cruz Rizzolo RJ","year":"1988","journal-title":"Quintessence Int"},{"key":"e_1_2_6_16_1","first-page":"229","article-title":"Intraoral anesthesia of the cervical plexus responsible for the sensory innervation of the platysma muscle or skin of the neck","volume":"31","author":"De Arruda JV","year":"1974","journal-title":"Rev Bras Odontol"},{"key":"e_1_2_6_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0099-2399(87)80097-3"},{"key":"e_1_2_6_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0099-2399(84)80270-8"},{"key":"e_1_2_6_19_1","doi-asserted-by":"publisher","DOI":"10.1002\/ca.22369"},{"key":"e_1_2_6_20_1","doi-asserted-by":"publisher","DOI":"10.1146\/annurev.physiol.61.1.143"},{"key":"e_1_2_6_21_1","doi-asserted-by":"publisher","DOI":"10.2344\/0003-3006(2007)54[163:AEOBAL]2.0.CO;2"},{"key":"e_1_2_6_22_1","first-page":"649","article-title":"Survey of local anesthetic use by ontario dentists","volume":"75","author":"Gaffen AS","year":"2009","journal-title":"J Can Dent Assoc"},{"key":"e_1_2_6_23_1","doi-asserted-by":"publisher","DOI":"10.1148\/radiology.220.1.r01jl05186"},{"key":"e_1_2_6_24_1","doi-asserted-by":"publisher","DOI":"10.1615\/CritRevTherDrugCarrierSyst.v25.i5.20"},{"key":"e_1_2_6_25_1","first-page":"357","volume-title":"Endodontics","author":"Ingle JI","year":"2002"},{"key":"e_1_2_6_26_1","doi-asserted-by":"publisher","DOI":"10.14219\/jada.archive.1983.0307"},{"key":"e_1_2_6_27_1","first-page":"153","article-title":"The inferior alveolar injections for fillings","volume":"6","author":"Jeffries CN","year":"1944","journal-title":"Br Dent J"},{"key":"e_1_2_6_28_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.joen.2007.11.019"},{"key":"e_1_2_6_29_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.joen.2007.09.006"},{"key":"e_1_2_6_30_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.joen.2005.09.016"},{"key":"e_1_2_6_31_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.joen.2011.12.006"},{"key":"e_1_2_6_32_1","doi-asserted-by":"publisher","DOI":"10.1002\/ca.22221"},{"key":"e_1_2_6_33_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00276-007-0202-8"},{"key":"e_1_2_6_34_1","first-page":"1235","article-title":"Endodontia\u2014The anesthetic phase","volume":"12","author":"Lubit EC","year":"1948","journal-title":"Dent Items Int"},{"key":"e_1_2_6_35_1","first-page":"264","article-title":"Intraosseus anaesthesia","volume":"15","author":"Magnus GD","year":"1968","journal-title":"Anesth Prog"},{"key":"e_1_2_6_36_1","doi-asserted-by":"publisher","DOI":"10.14219\/jada.archive.2011.0340"},{"key":"e_1_2_6_37_1","doi-asserted-by":"publisher","DOI":"10.14219\/jada.archive.2000.0237"},{"key":"e_1_2_6_38_1","first-page":"8","article-title":"Prevalence of referred pain with pulpal origin in the head, face and neck region","volume":"2","author":"Mardani S","year":"2008","journal-title":"IEJ"},{"key":"e_1_2_6_39_1","first-page":"143","article-title":"A comparative study of direct mandibular nerve block and the akinosi technique","volume":"8","author":"Mart\u00ednez Gonz\u00e1lez JM","year":"2003","journal-title":"Med Oral"},{"key":"e_1_2_6_40_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.joen.2008.11.025"},{"key":"e_1_2_6_41_1","first-page":"19S","article-title":"The use of the mandibular infiltration anesthetic technique in adults","volume":"142","author":"Meechan JG","year":"2011","journal-title":"JADA"},{"key":"e_1_2_6_42_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.tripleo.2009.08.027"},{"key":"e_1_2_6_43_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0099-2399(06)80849-6"},{"key":"e_1_2_6_44_1","first-page":"980","article-title":"Accessory mandibular foramina","volume":"70","author":"Nevin M","year":"1948","journal-title":"Dent Items Int"},{"key":"e_1_2_6_45_1","first-page":"5","article-title":"Sensory nerves and anesthesia of the teeth and jaws","volume":"5","author":"Novitzky J","year":"1938","journal-title":"Mod Dent"},{"key":"e_1_2_6_46_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0099-2399(98)80053-8"},{"key":"e_1_2_6_47_1","first-page":"372","article-title":"Anesthetic efficacy of different volumes of lidocaine with epinephrine for inferior alveolar nerve blocks","volume":"50","author":"Nusstein J","year":"2002","journal-title":"Gen Dent"},{"key":"e_1_2_6_48_1","doi-asserted-by":"publisher","DOI":"10.1097\/00004770-200311000-00010"},{"key":"e_1_2_6_49_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.DON.0000140565.88940.60"},{"key":"e_1_2_6_50_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cden.2009.12.003"},{"key":"e_1_2_6_51_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0099-2399(98)80011-3"},{"key":"e_1_2_6_52_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.joen.2011.09.009"},{"key":"e_1_2_6_53_1","doi-asserted-by":"publisher","DOI":"10.1034\/j.1601-1546.2002.30103.x"},{"key":"e_1_2_6_54_1","first-page":"169","volume-title":"Cirugia bucal con patologia clinica y terapeutica","author":"Ries Centeno GA.","year":"1968"},{"key":"e_1_2_6_55_1","doi-asserted-by":"publisher","DOI":"10.14219\/jada.archive.2007.0324"},{"key":"e_1_2_6_56_1","first-page":"276","article-title":"Evaluation of mandibular infiltration versus block anesthesia in pediatric dentistry","volume":"64","author":"Sharaf AA","year":"1997","journal-title":"ASDC J Dent Child"},{"key":"e_1_2_6_57_1","doi-asserted-by":"publisher","DOI":"10.14219\/jada.archive.1946.0234"},{"key":"e_1_2_6_58_1","first-page":"277","article-title":"The innervation of the dental tissues and its importance in regional anesthesia","volume":"53","author":"Stewart D","year":"1932","journal-title":"Br Dent J"},{"key":"e_1_2_6_59_1","first-page":"57","article-title":"The great auricular nerve: A case report and review of anatomy","volume":"96","author":"Tong DC","year":"2000","journal-title":"N Z Dent J"},{"key":"e_1_2_6_60_1","first-page":"41","article-title":"Local anesthetic failure associated with inflammation: Verification of the acidosis mechanism and the hypothetic participation of inflammatory peroxynitrite","volume":"1","author":"Ueno T","year":"2008","journal-title":"J Inflamm Res"},{"key":"e_1_2_6_61_1","unstructured":"UzbelgerD.Temple University of the Commonwealth System of Higher Education.2005. Improved intraoral cervical plexus anesthetic technique. US Copyright TXu 1\u2010228\u2010152."},{"key":"e_1_2_6_62_1","unstructured":"Uzbelger\u2010FeldmanD BitnerD AxxKT ChattopadhyayA.2007.Effectiveness of supplemental cervical plexus anesthetic technique for achieving anesthesia in mandibular molars with irreversible pulpitis.J Endod33:345."},{"key":"e_1_2_6_63_1","first-page":"67","article-title":"Intraosseous anesthetic techniques as first\u2010line techniques: Can they numb teeth with a pulpitis? Retrospective study on 110 cases","volume":"1307","author":"Villette A","year":"2008","journal-title":"Chir Dent Fr"},{"key":"e_1_2_6_64_1","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.16.4.644"}],"container-title":["Clinical Anatomy"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Fca.22543","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Fca.22543","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ca.22543","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/ca.22543","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ca.22543","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,6]],"date-time":"2023-09-06T02:45:37Z","timestamp":1693968337000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/ca.22543"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2015,4,10]]},"references-count":63,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2015,7]]}},"alternative-id":["10.1002\/ca.22543"],"URL":"https:\/\/doi.org\/10.1002\/ca.22543","archive":["Portico"],"relation":{},"ISSN":["0897-3806","1098-2353"],"issn-type":[{"value":"0897-3806","type":"print"},{"value":"1098-2353","type":"electronic"}],"subject":[],"published":{"date-parts":[[2015,4,10]]}}}