Efficacy of inferior alveolar nerve block and intraligamentary anesthesia in the extraction of primary mandibular molars: A randomized controlled clinical trial

Abstract

Objective: The study aims to compare the effectiveness and quality of intraligamentary anesthesia (ILA) and inferior alveolar nerve block (IANB) for primary mandibular molar extraction. Methods: This prospective, randomized clinical study included patients aged 5 to 13 years scheduled for primary mandibular molar extraction. A total of 208 participants were randomly allocated into two groups (n = 104 each group), IANB and ILA, who were administered 2% lignocaine with epinephrine 1:100,000. Patients rated their pain during injection and extraction (VAS pain score). Frankl’s behavior rating score, quality of anesthesia as perceived by clinician, and duration of procedure were recorded. Demographic and other variables were analysed using Pearson x2 test, Pearson correlation coefficient, Fisher exact test, or an analysis of variance, as appropriate. Results: In patients who received IANB, the clinician reported a slightly better quality of anesthesia (p = 0.19) than those who received ILA (VAS score 1.3 ± 0.7 Vs 1.6 ± 0.4). Mean (±SD) score for pain during extraction were found be 1.7 (±0.6) for the IANB group and 1.8 (±0.5) for the ILA group. The clinician observed 46.2% of patients in the IANB group and 39.4% of patients in the ILA group had no discomfort during extraction. Frankl’s behavior score was negatively correlated with the quality of anesthesia and the time taken to complete the extraction (p = 0.017 and p = 0.053, respectively). Conclusion: The efficacy of conventional ILA was similar to IANB, and thus ILA might be a good alternative to the IANB while extracting primary mandibular molars.

Keywords

• Inferior alveolar nerve block
• Intraligamentary anesthesia
• Primary mandibular molars
• Pain
• Visual analog scale