Evaluation of pulpal anesthesia in pediatric patients following intraligamentary injection as a primary technique in permanent mandibular molars with irreversible pulpitis: An in vivo study

Abstract

Background: Pain management is a crucial aspect of pediatric dentistry. There is a lot of fear and anxiety associated with administration of local anesthesia in children but it is the most exercised and proved to be the most reliable method to manage pain and achieve analgesia in a particular region of the jaw. Use of local anesthesia in children has to be done judiciously right from choosing the local anesthetic drug, amount of local anesthetic used and the technique used to administer local anesthesia. Methodology: 24 Patients reporting to the Department of Pediatric and Preventive Dentistry, where 12 patients were administered two site and other 12 patients were administered four site intraligamentary injection as a primary technique in permanent mandibular molars with irreversible pulpitis. Results: In this study two different sites for intraligamentary injection were compared and the two site technique did not achieve complete anesthesia and had to be supplemented by inferior alveolar nerve block in all patients. In four site technique 3 out of 12 patients experienced complete anesthesia. The difference in the pain perception in two groups All patients experienced less pain in four site as compared to 2 site injection during RCO. Conclusion: Inferior alveolar nerve block still remains the “Gold standard” to treat mandibular molars with irreversible pulpitis. If the IANB is not adequate, it can always be supplemented by the intraligamentary injection (or other supplemental injections) and achieve better pain control when using manual conventional systems.

Keywords: Local anesthesia, Intraligamentary anesthesia, Two site injection technique, four site injection technique, Pharmacological behavior management