DEFINITION (Write this first in exam)
The Vazirani–Akinosi technique is a closed-mouth mandibular nerve block in which local
anesthetic solution is deposited in the pterygomandibular space at the level of the
mandibular foramen without requiring the patient to open the mouth.
👨⚕️ DEVELOPED BY
● Described by S. Vazirani
● Popularized by George Akinosi
That’s why it is called Vazirani–Akinosi block.
🧠 WHY IS IT IMPORTANT?
⭐ Used when patient cannot open mouth
⭐ Best alternative when IANB fails
⭐ Ideal for trismus cases
This is commonly asked as:
“Which nerve block is indicated in trismus?”
Answer → Akinosi (Closed Mouth Block)
🎯 NERVES ANESTHETIZED
● Inferior alveolar nerve
● Incisive nerve
● Mental nerve
● Lingual nerve
● Often mylohyoid nerve
It provides similar anesthesia to IANB, but via a different approach.
📍 AREAS ANESTHETIZED
Structure Anesthesia
Mandibular teeth (one side) YES
Body of mandible YES
Lower lip YES
Chin YES
Lingual soft tissue YES
Buccal soft tissue of molars NO (needs long buccal nerve block)
📌 INDICATIONS (Very Important)
● Trismus
● Limited mouth opening
● Failed IANB
● Fractured mandible
● Patients unable to tolerate wide opening
❌ CONTRAINDICATIONS
● Infection at injection site
● Severe swelling in pterygomandibular space
● Uncooperative patient
📍 ANATOMICAL LANDMARKS (VIVA GOLD)
The Vazirani–Akinosi technique is a closed-mouth mandibular nerve block in which local
anesthetic solution is deposited in the pterygomandibular space at the level of the
mandibular foramen without requiring the patient to open the mouth.
👨⚕️ DEVELOPED BY
● Described by S. Vazirani
● Popularized by George Akinosi
That’s why it is called Vazirani–Akinosi block.
🧠 WHY IS IT IMPORTANT?
⭐ Used when patient cannot open mouth
⭐ Best alternative when IANB fails
⭐ Ideal for trismus cases
This is commonly asked as:
“Which nerve block is indicated in trismus?”
Answer → Akinosi (Closed Mouth Block)
🎯 NERVES ANESTHETIZED
● Inferior alveolar nerve
● Incisive nerve
● Mental nerve
● Lingual nerve
● Often mylohyoid nerve
It provides similar anesthesia to IANB, but via a different approach.
📍 AREAS ANESTHETIZED
Structure Anesthesia
Mandibular teeth (one side) YES
Body of mandible YES
Lower lip YES
Chin YES
Lingual soft tissue YES
Buccal soft tissue of molars NO (needs long buccal nerve block)
📌 INDICATIONS (Very Important)
● Trismus
● Limited mouth opening
● Failed IANB
● Fractured mandible
● Patients unable to tolerate wide opening
❌ CONTRAINDICATIONS
● Infection at injection site
● Severe swelling in pterygomandibular space
● Uncooperative patient
📍 ANATOMICAL LANDMARKS (VIVA GOLD)
