Comparison of infiltration (INF) and inferior alveolar nerve block (IANB) injection techniques in bilateral therapeutic removal of mandibular premolars.

Balamurugan Rajendran,Sahana Pushpa Thaneraj

doi:10.34172/joddd.2021.044

Abstract

Background. The present study aimed to evaluate and compare the anesthetic effect of infiltration (INF) and inferior alveolar nerve block (IANB) techniques for bilateral therapeutic extraction of mandibular premolars. Methods. One hundred patients requiring bilateral therapeutic removal of mandibular premolars were included in the study. For the extraction of the mandibular right premolar tooth, INF was used, and after one week, the mandibular left premolar tooth was extracted using the IANB. The effect of anesthesia between the two techniques was compared and evaluated by ANOVA using SPSS. Results. INF was successful in 78% of cases, whereas IANB was successful only in 22% of cases. Furthermore, INF had a significantly better anesthetic effect than IANB (P < 0.05). During pain assessment during the anesthetic drug injection and the procedure, two patients in the INF and five patients in the IANB group reported minimal pain during extraction (P > 0.05). The onset of the anesthetic effect was faster in the INF group, while the duration of the effect was longer in the IANB group. Conclusion. INF was a more efficacious local anesthetic technique with high success rate than the IANB technique.

Highlights

Injection techniques for the extraction of posterior mandibular teeth are important for oral and maxillofacial surgeons in controlling and eliminating pain during dental procedures
The inferior alveolar nerve block (IANB) injection technique has been widely used over the past years to extract posterior mandibular teeth, as it is believed that the thick cortical bone of the mandible impedes adequate diffusion of the anesthetic solution
Pain during removal of mandibular premolars: Pain during removal of mandibular premolar was experienced by two patients when the INF technique was used, whereas five patients reported pain during the procedure when IANB was given

Summary

Introduction

Injection techniques for the extraction of posterior mandibular teeth are important for oral and maxillofacial surgeons in controlling and eliminating pain during dental procedures. The IANB technique is associated with numerous serious complications, such as nerve damage, transient facial paralysis, hematoma, trismus, and increased duration of anesthesia, with possible injuries to the lip and tongue.[1] To avoid such complications, researchers have constantly worked towards alternate injection techniques with a similar anesthetic effect as that of IANB. Some of such techniques are the periodontal intraligamentary injection (PDL) and local infiltration (INF).[2] PDL injection has a rapid onset of action, the duration of the anesthetic effect is much shorter but inadequate to perform dentoalveolar surgical procedures in the mandible. INF was a more efficacious local anesthetic technique with high success rate than the IANB technique

Methods

Results

Conclusion