Editing Local anesthetic (section)

=== Vazirani–Akinosi technique ===
The Vazirani–Akinosi technique is also known as the closed-mouth mandibular nerve block. It is mostly used in patients who have limited opening of the mandible or in those that have trismus; spasm of the muscles of mastication. The nerves which are anesthetised in this technique are the inferior alveolar, incisive, mental, lingual and mylohyoid nerves.

Dental needles are available in two lengths, short and long. As Vazirani–Akinosi is a local anesthetic technique which requires penetration of a significant thickness of soft tissues, a long needle is used. The needle is inserted into the soft tissue which covers the medial border of the mandibular ramus, in region of the inferior alveolar, lingual and mylohyoid nerves. The positioning of the bevel of the needle is very important as it must be positioned away from the bone of the mandibular ramus and instead towards the midline.<ref name="Malamed_2013">{{cite book|title=Handbook of local anesthesia| vauthors = Malamed SF |date=2013|publisher=Elsevier|isbn=9780323074131|edition=6th|location=St. Louis, Missouri|oclc=769141511|name-list-style=vanc}}</ref>