Accessory Innervation Anesthetic Protocol: From Research Theory to Clinical Reality

Dr. Daniel Uzbelger Feldman, Accessory Innervation Anesthetic Protocol: From Research Theory to Clinical Reality
Speaker: Dr. Daniel Uzbelger Feldman
Category: Anesthesia
CE Credits: 1.5
Format: PDF
This course describes how the accessory innervation anesthetic protocol can be used for profound pulpal anesthesia of the adult posterior mandible. It will discuss how the accessory innervation theory...more
  • Released: 4/2/2018
  • Expiration Date: 6/30/2025
  • Review Date: 6/30/2022
CE Details
Credit Details
This electronically delivered self-instructional program is designated for 1.5 hours of CE credit by Farran Media.
AGD Code: 340.

There is no fee to view this course. There is a fee of $36 to take the exam and claim CE credits for this course.

The inferior alveolar nerve block has the highest failure rate not only in dental local anesthesia, but also among all local anesthetic blocks in medicine. The “accessory innervation to the inferior alveolar nerve” theory supports the idea that incidents of unsuccessful anesthesia may result from innervations of the adult mandible arising from the cervical plexus in addition to the auriculotemporal, buccal, mental, incisive, mylohyoid, and lingual nerves. Hence, to achieve profound pulpal anesthesia in the posterior mandible, an accessory innovation anesthetic protocol that anesthetizes all the accessory nerves has been clinically proposed. Three different accessory innervation anesthetic protocol approaches are described in this article, as well as how to overcome pulpal anesthesia failure by implementing the intraoral cervical plexus anesthetic technique. This protocol will help alleviate patient’s fear to the dental chair while improving our profession’s reputation.

Educational Objectives:
Upon completion of this course, you should be able to:
  • 1. Understand the problems associated with anesthetic failures in permanent dentition with the use of currently available anesthetic techniques.
  • 2. Identify how accessory innervation may play a pivotal role in the high percentage of anesthetic failure on the posterior mandible.
  • 3. Comprehend the cervical plexus nerve description and distribution in the mandible.
  • 4. Recognize how these variations of anatomy allow for clinical decisions for implementing supplemental anesthetic techniques.
  • 5. Administer the intraoral cervical plexus anesthetic technique to their patients.
  • 6. Provide the accessory innervation anesthetic protocol to their patients.
Description of Speaker:
Dr. Daniel Uzbelger Feldman earned an odontology dental degree (the equivalent of a DDS) from Central University of Venezuela in 1995, and his postgraduate certificate in endodontics from Carlos J. Bello Hospital in 1997. Since 2003, he has been affiliated with the Department of Endodontology at Temple University Kornberg School of Dentistry (TUKSoD), where he earned his DMD certificate in 2006. Uzbelger Feldman is involved with research activities in the low-dose dental imaging, accessory innervation in dental anesthesia and endodontic obturation materials fields at TUKSoD. With 22 years of experience, he worked five years at the private practice in Philadelphia, and now serves patients in the Cleveland suburbs.

In the past 12 months, the lecturer/speaker declare that they have had a financial interest, arrangement or affiliation within the field of dentistry or health care with the following: Real Time Technologies, LLC, and Temple University Student/Faculty Research Grant.

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Farran Media is an ADA CERP Recognized Provider. ADA CERP is a service of the American Dental Association to assist dental professionals in identifying quality providers of continuing dental education. ADA CERP does not approve or endorse individual courses or instructors, nor does it imply acceptance of credit hours by boards of dentistry. Concerns or complaints about a CE provider may be directed to the provider or to ADA CERP at For any questions, please contact Nareg Apelian, DMD, Director of Continuing Education at
American General Dentistry (AGD), Program Approval for Continuing Education (PACE) approved, FAGD / MAGD Credit Farran Media is a nationally approved PACE Program Provider by the Academy of General Dentistry. Approval does not imply acceptance by any regulatory authority or AGD endorsement. The current term of approval extends from 1/1/2023 to 12/31/2026. Provider ID# 304396
This activity meets the educational criteria required for verifiable Continuing Professional Development under the General Dental Council Lifelong Learning scheme and represents 1.5 hours of verifiable CPD.

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To reap the full benefits of this CE course, the presenters (Howie Horrocks and Mark Dilatush) have agreed to create a marketing plan specifically tailored to your practice and your specific market area. Having your marketing plan printed and open while you view the course material, will greatly individualize your learning experience.
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