Periodontal complications with intrabony anesthesia

Abstract

During intraosseous anesthesia (IOA), the cancellous bone is infiltrated directly with the anesthetic through the cortical bone. Advantages of IOA are seen in the immediate onset of action without co-anesthetics of the surrounding soft tissue and in the low dosage. The industry-supported statement that no necroses of the periodontal structures are to be feared and that there is no risk of fracture of the injection needle is refuted by clinical progress reports form the practice. These risks are rarely mentioned in current studies; on the contrary - IOA continues to be presented as particularly low in complications. In contrast, more attention should be paid to whether necrotic bone changes can be displayed over time, which may be related to the anesthesia technique. It would be desirable to systematically conduct clinical studies in the future with the aim of recording possible long-term damage by the IOA. In the present study, this type of anesthesia is evaluated with regard to its clinical application and periodontal risks, and possible examples of the course of complication are radiographically presented and discussed based on the rather scarce literature.