The investigators found that the mylohyoid injection did not significantly enhance pulpal anesthesia of the inferior alveolar nerve block. Therefore, the result of the study does not lend much credibility to the notion that the mylohyoid nerve is a major factor in failure with the inferior alveolar nerve block.Accuracy of the Injection It has been theorized that an inaccurate injection contributes to inadequate mandibular anesthesia.herefore, the use of commercial needles with markers to indicate needle bevel is not necessary. Cross Innervation Cross innervation from the contralateral inferior alveolar nerve has been implicated in failure to achieve anesthesia in anterior teeth after an inferior alveolar injection.