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This article reviews research and author experience behind Intraligamentary Local Anaesthesia (ILA) and Infiltration Local Anaesthesia (IFA) with Inferior Alveolar Nerve Block (IANB). In particular, the use of ILA with 4% articaine is discussed as an effective anaesthetic technique to replace both IANB and IFA for the purpose of tooth extraction in the posterior mandible. ILA also avoids the possible complications associated with IANB. Other advantages and some shortfalls of the ILA technique are described in relation to primary dental care. The technique for achieving ILA is described.
CPD/Clinical Relevance: The ILA technique with articaine is a simple, swift and effective alternative to IANB and IFA for extraction of posterior teeth in the mandible in primary dental care. ILA has fewer potential debilitating complications than IANB and is likely to be more effective than IFA.
Article
The Intraligamentary Local Anaesthetic (ILA) or ‘Periodontal Anaesthetic’ technique has been described as a misnomer, as it enters the cancellous bone through natural perforations and is, in effect, an intra-osseous, as opposed to a periodontal, local anaesthetic. In addition to the similar Infiltration Local Anaesthetic (IFA) or ‘Supraperiosteal Injection’ technique, the ILA is not commonly taught or used in dental schools for extraction of mandibular posterior teeth. The ‘go to’ method for anaesthesia of posterior teeth in the mandible has often been the Inferior Alveolar Nerve Block (IANB). A recent paper in Dental Update briefly mentions ILA as a useful anaesthetic technique for tooth extraction, that might replace IANB.1 In this review, research behind ILA is discussed in detail and compared with IANB and IFA. The anaesthetic and technique for ILA is also discussed for the purpose of extraction of posterior teeth in the mandible, with relevance to primary dental care.
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