Modified mylohyoid nerve anesthesia with 4% articaine with epinephrine and dexamethasone for mandibular dentoalveolar surgery

Introduction. The use of the modified mylohyoid nerve anesthesia (MMA) technique for dentoalveolar surgery is uncommon. Case outline. We present a 51-year-old Caucasian female patient experiencing chronic inflammation and pain in the area of the missing lower left second premolar and molars. Cone-beam CT imaging of the mandible revealed impaction of the mandibular permanent second premolar; 3.5 mL of 4% articaine and 1:100,000 epinephrine were administered with 0.5 mL of dexamethasone using the MMA technique behind the site of the third molar. The pain was measured through the visual analog scale and recorded a value of 8 mm, with the duration of anesthesia being 270 minutes. Conclusion. Modified mylohyoid nerve anesthesia can be utilized independently as a primary anesthesia or as a supplementary option for insufficiently effective or failed Halsted anesthesia.