Abstract
ObjectiveTo compare the effectiveness and complications of intraligamentary anesthesia (ILA) with conventional inferior alveolar nerve block (IANB) during injection and dental treatment of mandibular posterior teeth.Materials and methodsIn this randomized, prospective clinical trial, 72 patients (39 males, 33 females), scheduled for dental treatment of mandibular posterior teeth, were randomly allocated to ILA group (n = 35) received ILA injection or IANB group (n = 37) received the conventional IANB. Our primary outcome was to assess pain and stress (discomfort) during the injection and dental treatment, using the numeric rating scale (NRS) from 0 to 10 (0 = no pain, 10= the worst pain imaginable), whereas recording 24-h postoperative complications was our secondary outcomes.ResultsPatients in ILA group reported significantly less pain during injection when compared with IANB group (p = 0.03), while pain during dental treatment was similar in both groups (p = 0.2). Patients in both groups also reported similar law values of discomfort during treatment (p = 0.7). Although no signs of nerve contact or any other postoperative complications were observed, five patients in IANB group (none in ILA group) reported temporary irritations.ConclusionThis study showed equivalent effectiveness of both intraligamentary anesthesia and conventional inferior alveolar nerve block, for pain control during routine dental treatment of mandibular posterior teeth. Nevertheless, ILA showed significantly less pain during injection. No major postoperative complications in both groups were observed.Clinical relevanceILA could be considered as an effective alternative for routine dental treatment.Trial registrationNCT04563351
Highlights
Pain is a relevant problem in dental treatment [1], making the administration of local anesthetics a necessary and routine measure for various dental procedures [2]
Seventy-two adult patients (39 males, 33 females) were enrolled and participated in this study. They were randomizer located in two groups, inferior alveolar nerve block (IANB) group (37 teeth were treated in 37 patients) and intraligamentary anesthesia (ILA) group (35 teeth were treated in 35 patients)
The amount of local anesthesia that had been applied was significantly lower for ILA (p = 0.00, Fig. 2)
Summary
Pain is a relevant problem in dental treatment [1], making the administration of local anesthetics a necessary and routine measure for various dental procedures [2]. The evidence suggests that IANB is relatively painful and has a comparatively higher failure rate [7]. It has a technique-immanent risk, such as transient or even persistent damage to the lingual and/or the inferior alveolar nerve [8]. It may provoke intravascular injections, hematoma, Clin Oral Invest (2021) 25:4825–4832. Excluded (n=0) Not meeting inclusion criteria (n=0) Declined to participate (n=0) Other reasons (n= 0). Allocated to intervention:(n=37) ReceFivigeudrea1llocated intervention (n=37) Did not receive allocated intervention (give reasons) (n=0). Allocated to intervention (n=35) Received allocated intervention (n=35 ) Did not receive allocated intervention (give reasons) (n=0 ). Analysed (n=37) Excluded from analysis (give reasons) (n=0)
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