Comparison of the effectiveness of intraligamentary anesthesia and inferior alveolar nerve block on mandibular molar teeth in pediatric patients: a randomized controlled clinical study.

OBJECTIVES

The study aimed to compare the two local anesthetic techniques: inferior alveolar nerve block (IANB) and intraligamentary anesthesia (ILA) during the restorative treatment of mandibular first permanent molars in pediatric patients.

MATERIALS AND METHODS

In this randomized, controlled, cross-over, single-blind, split-mouth study, participants were divided into two groups: group 1, ILA in the first session and IANB in the second session, and group 2, IANB in the first session and ILA in the second session. The pain perception was analyzed using the visual analog scale (VAS) and Wong-Baker FACES pain rating scale (WBFPRS). Heart rate, arterial oxygen saturation (SpO), and postoperative complications were recorded. The data were analyzed with the Brunner-Langer model, Spearman correlation analysis, Fisher's exact t-test, chi-square, and McNemar tests.

RESULTS

Seventy-eight patients aged between 6 and 12 years were included. The session effect was not statistically significant in ILA (p = 0.762 and p = 0.411) for pain scores while it was significant in IANB (p < 0.001 for each score). There was no significant difference in the VAS, WBFPRS, heart rate, and SpO between the anesthesia techniques (p = 0.454, p = 0.436, p = 0.406, p = 0.285, respectively). Postoperative complications increased in the IANB technique in the first session.

CONCLUSIONS

Intraligamentary anesthesia may be an alternative technique to IANB for the restorative treatment of mandibular first permanent molars in pediatric patients. In the first session, clinicians may choose the ILA instead of IANB.

CLINICAL RELEVANCE

In clinical procedures, administering anesthesia, which is effective, is less painful, and poses relatively low complication risk, has significant importance in sustaining children's cooperation with dental treatment.