Pulpal anaesthesia for mandibular central incisor teeth: a comparison of infiltration and intraligamentary injections.
OBJECTIVE
This study compared the anaesthetic efficacy of infiltration and intraligamentary injections in the permanent mandibular central incisor.


METHODS
Twelve healthy volunteers received each of the following methods of anaesthesia for one of their mandibular central incisors over four visits. 1 Labial infiltration of 1.0 mL. 2 Lingual infiltration of 1.0 mL. 3 Labial infiltration of 0.5 mL plus lingual infiltration of 0.5 mL. 4 Intraligamentary injection of (118 mL. Two percent lidocaine with 1: 80 000 adrenaline and 30 gauge needles were used throughout. Electrical pulp testing was performed before injection and every 2 min up to 30 min after the injection. Injection discomfort was recorded on a 100-mm visual analogue scale. Data were compared with ANOVA, Student's t-test and chi2 tests.


RESULTS
Anaesthesia varied between techniques(F = 9.3, P < 0.001). The incidence of anaesthesia at any time was as follows: 50% success for labial infiltration; 50% success for lingual infiltration: 92% success for combined labial and lingual infiltration; 0% success for intraligamentary injections (chi2 = 20; P < 0.001). The mean (+/-SD) VAS score for intraligamentary injection discomfort was 28 +/- 12 mm, for buccal infiltrations 17 +/- 8 mm and for lingual infiltrations 16 +16 mm. Intraligamentary injections were more uncomfortable than buccal (t = 3.7: P < 0.01) and lingual infiltrations (t = 2.67: P < 0.05).


CONCLUSIONS
The most reliable method of the techniques investigated for obtaining pulpal anaesthesia in mandibular permanent central incisors was a combination of labial and lingual infiltration. Intraligamentary injections were unreliable and were more uncomfortable than infiltrations in the mandibular central incisor region.
Department of Oral and Maxillofacial Surgery, Newcastle Dental School, University of Newcastle upon Tyne, UK. j.g.meechan@ncl.ac.uk
J G
JG
Meechan
J I M
JI
Ledvinka
D000328:Adult; D000704:Analysis of Variance; D000762:Anesthesia Recovery Period; D000766:Anesthesia, Dental / Q000379:methods*; D000772:Anesthesia, Local; D000779:Anesthetics, Local / Q000008:administration & dosage*; D003782:Dental Pulp / Q000187:drug effects*; D003791:Dental Pulp Test; D006801:Humans; D007180:Incisor; D007267:Injections; D008012:Lidocaine / Q000008:administration & dosage*; D008046:Lip; D008334:Mandible; D010147:Pain Measurement; D010513:Periodontal Ligament; D014059:Tongue
D000779:Anesthetics, Local; D008012:Lidocaine