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

Bahaa R Youssef, Andreas Söhnel, Alexander Welk, Mohamed H Abudrya, Mohamed Baider, Mohammad Alkilzy, Christian Splieth, Bahaa R Youssef, Andreas Söhnel, Alexander Welk, Mohamed H Abudrya, Mohamed Baider, Mohammad Alkilzy, Christian Splieth

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.

Keywords: Dentistry; Inferior alveolar nerve block; Local anesthetic; Pain; RCT.

Conflict of interest statement

The authors declare that they have no conflict of interest.

© 2021. The Author(s).

Figures

Fig. 1
Fig. 1
Show the CONSORT diagram
Fig. 2
Fig. 2
The total injection amount (ml) of local anesthetic solution during the entire procedure for inferior alveolar nerve block (IANB) vs. intraligamentary anesthesia (ILA)
Fig. 3
Fig. 3
Assessment of the differences between pain of injection, pain during treatment, and unpleasantness of treatment for inferior alveolar nerve block (IANB) vs. intraligamentary anesthesia (ILA) by using a 10-point segmented numeric rating scale (NRS)
Fig. 4
Fig. 4
The duration of soft tissue anesthesia (min) for inferior alveolar nerve block (IANB) vs. for intraligamentary anesthesia (ILA)
Fig. 5
Fig. 5
Assessment of the differences between pain of injection, pain during treatment, and unpleasantness of treatment for different intraligamentary syringe systems (Softjet, Citojet, and Ultrajet) by using a 10-point segmented numeric rating scale (NRS)

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