Intraligamentary anesthesia: Benefits and limitations

Intraligamentary anesthesia was described in France early in the 20th century as a novel and effective method of dental local anesthesia, but the method did not become established because of the inadequacy of dental instruments available at the time. Today, the use of a state-of-the-art armamentarium and the administration of well-proven anesthetic agents with intraligamentary anesthesia reduce the experience of typical unwanted effects, that is, sensation of elongation, pressure pain, precontact after the end of the analgesia, and reversible tissue changes. Dosing lever and dosing wheel syringes in combination with system-adapted injection needles enable the operator to feel the back-pressure and inject the anesthetic smoothly into the periodontal ligament. The results of most recent studies show that periodontal ligament injections do not generate unwanted effects when sensible instruments are used, proven anesthetics are administered, and the anesthesia method is practiced lege artis and mastered safely by the operator. This article discusses the advantages and technique of intraligamentary anesthesia and presents results from recent studies in the literature. Keywords: dosing lever syringe, dosing wheel syringe, intraligamentary anesthesia, periodontal ligament injection, pistol-type syringe, single-tooth anesthesia, unwanted effects