Sohum Pandya

Title: No block? no problem: Intraligamentary anaesthesia with a conventional syringe

Abstract

Aim: This research/ audit assessed the efficacy of intraligamentary anaesthesia (ILA) using a conventional syringe for mandibular molar extractions and investigated the incidence of alveolar osteitis (dry socket). The potential impact of smoking on dry socket incidence was also explored.

Methods: A two-cycle retrospective audit was conducted involving 196 patients undergoing mandibular molar extractions under ILA. Anaesthetic was administered at six periodontal sites using articaine, lidocaine, or a combination. The first cycle examined ILA efficacy and dry socket incidence. The second cycle added smoking status (including cigarettes, e-cigarettes, and cannabis) to assess its correlation with dry socket. Efficacy was determined by the need for supplemental anaesthesia, and dry socket was assessed via follow-up calls.

Results: ILA was sufficient in 80-81% of cases across both cycles, with 15–16% requiring supplemental inferior dental blocks. Dry socket occurred in 15% of patients in the first cycle and 4% in the second. Of those with dry socket in the second cycle, 50% were smokers. Smoking prevalence among all patients was 27%.

Discussion: ILA using a conventional syringe demonstrated a comparable success rate (80–81%) to that reported for ILA with specialist syringes, suggesting it is a viable alternative in general dental settings. While the dry socket rate fell within the reported range (3.2–15.7%), findings suggest the association between smoking and increased risk. Limitations include sample size and retrospective design.

Conclusion: ILA with a conventional syringe is an effective anaesthetic technique for mandibular molar extractions and may not necessarily increase the dry socket rate when compare to existing literature. Smoking likely contributes to an increased risk of dry socket. Further research with a larger sample and prospective design is recommended to validate findings.