Back to Journals » Journal of Pain Research » Volume 11

Efficacy of intraligamentary anesthesia in maxillary first molar extraction

Authors Ryalat ST, Al-Shayyab MH, Amin W, AlRyalat SA, Al-Ryalat N, Sawair F

Received 6 April 2018

Accepted for publication 14 June 2018

Published 12 September 2018 Volume 2018:11 Pages 1829—1833


Checked for plagiarism Yes

Review by Single anonymous peer review

Peer reviewer comments 3

Editor who approved publication: Dr E Alfonso Romero-Sandoval

Soukaina Tawfiq Ryalat,1 Mohammad H Al-Shayyab,1 Wala Amin,2 Saif Aldeen AlRyalat,3 Nosaiba Al-Ryalat,4 Faleh Sawair1

1Department of Oral and Maxillofacial Surgery, Oral Medicine, and Periodontology, Faculty of Dentistry, University of Jordan, Amman, Jordan; 2Department of Prosthodontics, Faculty of Dentistry, University of Jordan, Amman, Jordan; 3Department of Ophthalmology, Faculty of Medicine, University of Jordan, Amman, Jordan; 4Department of Radiology and Nuclear Medicine, University of Jordan, Amman, Jordan

Introduction: Infiltration anesthesia (IA) is the method to anaesthetize maxillary teeth successfully. In contrast, intraligamentary anesthesia (ILA) has been used as supplementary anesthesia during tooth extraction, particularly when regional block anesthesia has failed. In this study, we compare the efficacy of and patient satisfaction with ILA vs IA when extracting maxillary first molar teeth.
Methods: Forty patients were enrolled in this study and 80 maxillary first molars extracted. All patients served as their own control, with ILA as the experimental side and IA as the control side. The two techniques were compared for efficacy using a visual analog scale (VAS) and patient satisfaction compared using a verbal rating scale (VRS).
Results: The mean VAS pain score for extraction using ILA was lower than that for IA (20.30±3.18 and 13.93±1.95 mm, respectively; P<0.001). For injection pain, the mean VAS pain score in the ILA side was higher than the IA side (42.28±4.51 and 31.73±3.1 mm, respectively; P<0.001). VRS results showed a higher number of patients who felt that pain during ILA was greater than expected compared with IA.
Conclusion: IA appears less painful during injection compared with ILA, and provides sufficient pain relief during extraction. However, ILA can be used when IA fails to achieve the desired pain suppression, as it provides higher extraction-pain relief.

Keywords: infiltration anesthesia, maxillary first molars, intraligamentary anesthesia, periodontal intraligamentary anesthesia

Creative Commons License This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at and incorporate the Creative Commons Attribution - Non Commercial (unported, v3.0) License. By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms.

Download Article [PDF]  View Full Text [HTML][Machine readable]