30 patients received 1.8 ml buccal infiltration combined with 0.2 ml intraligamentary injection of 4% articaine (1:100000 adrenaline).
Intraligamentary injections are one of the supplemental injections which raise the success rate to a reliable extent.
Comparison of injection pain, heart rate increase and post injection pain o articaine and lidocaine in a primary intraligamentary injection administered with a computer controlled local anesthetic delivery system.
Anesthetic Effectiveness of the supplemental intraligamentary injection, administered with a computer controlled local anesthetic delivery system in patients with irreversible pulpitis.
It may also be used as a primary technique for mandibular local anesthesia, though there are concerns about periodontal ligament injury with injecting large amounts for restorative reasons.27 Higher success rates for restorative procedures have been reported for intraligamental injections when compared to the inferior alveolar nerve block, even though intraligamental infiltration may need to be supplemented during procedures.28 Intraligamental injections are also technique sensitive, and may require special armamentarium to administer effectively, though equal success rates (50% to 96%) have been demonstrated when comparing different needles and equipment for Intraligamentary injections.3,27-30
Intraosseous LA has gone out of favour and has been superseded by Intraligamentary injections. Intraosseous was an effective primary31 or secondary technique, but required special equipment (bur, needle) to drill into bone and administer distal to the concerned tooth.32 The equipment should be available, and dentists trained in the use, for cases where other techniques have failed, or for use during surgical extractions.
The objective of this study was to compare the mean postoperative endodontic pain using prophylactic intraligamentary injection of piroxicam and lignocaine in teeth with irreversible pulpitis.
Group-A patients received supplemental intraligamentary injection of 0.4ml of 20mg/ml piroxicam as an active agent.
Key Words: Postoperative endodontic pain, Prophylactic Intraligamentary Injection, Piroxicam, Lignocaine, Irreversible pulpitis.
Inhibiting COX-2, blocks prostaglandin formation and ultimately prevents in ammation and sensitization of the peripheral nociceptors.6 It is also postulated that the intraligamentary injection enables the application of anti-in ammatory agents directly in the periapical intraosseous region.2,3
Thick cortical bone is thought to be responsible for poor perforation of blood supply to the posterior man-dibular region hence resulting in a higher incidence of dry socket.19 However, certain studies contest the fact by pointing out the larger blood network in the poste-rior region as compared to the anterior.14 Some inves-tigations have suggested the vasoconstrictors in intraligamentary injection
are responsible for dry socket.20 Sufficient literature is present challenging the earlier notion.21
A comparison of 2 topical anesthetics on the discomfort of intraligamentary injections
. Oral Surg Oral Med Oral Pathol 1999; 87: 362-365.