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Clinical Oral Investigations

, Volume 22, Issue 3, pp 1469–1475 | Cite as

Prospective clinical study comparing intraligamentary anesthesia and inferior alveolar nerve block for extraction of posterior mandibular teeth

  • P. W. Kämmerer
  • A. Adubae
  • I. Buttchereit
  • D. G. E. Thiem
  • M. Daubländer
  • B. Frerich
Original Article
  • 161 Downloads

Abstract

Objectives

The aim of the study was to compare the efficacy of intraligamentary anesthesia (ILA) with conventional inferior alveolar nerve block (IANB) for extraction of mandibular posterior teeth.

Materials and methods

In a prospective clinical trial, a total of 301 mandibular posterior teeth were extracted in 266 patients. Randomization was conducted into those who received ILA (patients n = 98; teeth n = 105) and those who received IANB (patient n = 140; teeth n = 140). Twenty-eight patients were subjected to bilateral mandibular dental extractions and received both ILA und IANB (teeth n = 56 (ILA n = 28; IANB n = 28)). The primary objective was to evaluate the differences in pain during injection, in pain during tooth extraction (numeric rating scale (NRS)), and in anesthetic quality (complete/sufficient vs. insufficient/no effect). Differences in latency time, amount of anesthetic solution, need for second injection, and duration of local numbness as well as in the incidence of dry socket were assessed.

Results

ILA had significant lower pain of injection (p < 0.001), shorter latency time (p < 0.001), and shorter duration of local numbness (p < 0.001) and required lesser amount of local anesthetic solution (p < 0.001) together with a similar anesthetic quality (p = 0.082) compared to IANB. Concerning pain during extraction (p = 0.211), frequency of second injection (p = 0.197), and incidence of dry socket (p = 0.178), no significant differences were detected.

Conclusion

ILA fulfills the requirements of a minimal invasive and patient-friendly local anesthetic technique. In accordance, it represents a safe and reliable alternative to IANB for extraction of mandibular posterior teeth.

Clinical relevance

ILA can be recommended for routine dental extractions.

Keywords

Intraligamentary anesthesia Periodontal ligament injection Inferior alveolar nerve block Mechanical injection syringe Pistol type syringe Ultraject® syringe Dental extraction Comparison 

Notes

Funding information

No funding was obtained.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards. Approval of the local ethics committee (No. A 2014-0129) was obtained.

Informed consent

Informed consent was obtained from all individual participants included in the study.

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Copyright information

© Springer-Verlag GmbH Germany 2017

Authors and Affiliations

  • P. W. Kämmerer
    • 1
  • A. Adubae
    • 1
  • I. Buttchereit
    • 1
  • D. G. E. Thiem
    • 1
  • M. Daubländer
    • 2
  • B. Frerich
    • 1
  1. 1.Department of Oral and Maxillofacial Surgery, Facial Plastic SurgeryUniversity Medical Centre RostockRostockGermany
  2. 2.Policlinic of Oral SurgeryUniversity Medical Centre MainzMainzGermany

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