RCT on the effectiveness of the intraligamentary anesthesia and inferior alveolar nerve block on pain during dental treatment

Abstract

Objective To 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 methods In 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. Results Patients 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. Conclusion This 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 relevance ILA could be considered as an effective alternative for routine dental treatment. Trial registration NCT04563351

Learning curve of intraligamentary anesthesia in dental education: a prospective, cross- sectional trial

“…ILA was often discussed as a supplementary technique when a conventional method such as IANB fails (14)(15)(16)(17). Current studies report similar or higher e ciency for ILA towards IANB (4,18,19). Consequently, concerning the bene ts of ILA, this technique should be trained before successful application.…”

Comparing intraosseous computerized anaesthesia with inferior alveolar nerve block in the treatment of symptomatic irreversible pulpitis: A randomized controlled trial

“…Although IANB is associated with an increased risk of burning sensations and/or lip or cheek bite injuries and, in very rare cases, nerve‐related adverse effects (Aquilanti et al, 2022; Youssef et al, 2021), very few adverse events were noted (only one case of bite for the IANB group). None of the potential side effects described with intraosseous anaesthesia (high occlusion for a few days, swelling; Coggins et al, 1996; Reisman et al, 1997; Zanjir et al, 2019) were recorded in the present study.…”

Comparison of dental anesthetic efficacy between the periodontal intraligamentary anesthesia and other infiltration anesthesia: a systematic review and meta-analysis

“…Moreover, concerning injection pain, the VAS scores of infiltration anesthesia are lower than intraligamentary anesthesia, and the scores of intraligamentary anesthesia are lower than IANB. Intraligamentary anesthesia can be an effective alternative to IANB since it avoids the potential complications associated with IANB ( Youssef et al, 2021 ; Yılmaz & Çağırır Dindaroğlu, 2023 ).…”