Intraligamentary anesthesia – a brief review of an underestimated anesthetic technique

A successful pain management through efficient local anesthesia is the basis for every dental therapy. On the one hand, patients expect a painless and comfortable dental treatment, which becomes crucial especially in subjects suffering from dental phobia [1]. On the other hand, the skill of a dentist or oral surgeon himself is often measured by the ability of achieving profound and successful local anesthesia and pain relief. There are different, more or less known options of local anesthesia in the dental area, first of all infiltration anesthesia (IA) as well as the inferior alveolar nerve block (IAN). While IA interrupts the pain perception in the area of injection, the second mentioned technique is related to the innervation area of the mandibular nerve. Indeed, beside the interruption of pain perception, both local anesthetic methods block also the function of sensitive and motor nerves [2]. As a consequence patients experience loss of sensitivity as well as total or partial loss of function of facial muscles and/or the tongue for the duration of the anesthesia [3]. The result is a temporary restriction of patients’ daily life with reduced ability in speaking and eating, but also the risk of bite and burn injuries. Moreover, it is well known, that a rare but major complication of IANB is represented by the lesion of the mandibular nerve with possible permanent disturbances of the nerve function [4].