Article: Volume 47 Number 3 Page 213 - March 2020

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  Dent Update 2020; 47: 213-216

Oral surgery:  Intraligamentary Local Anaesthesia for Posterior Mandibular Extractions

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Abstract: 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.

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.

Author notes: Ryan C Olley, PhD, BDS, BSc Hons(Lond), GCAP(KCL), AHEA MClinDent Hons(Lond), MPROS RCS(Edin), Senior Clinical Lecturer and Consultant in Restorative Dentistry, Cardiff University; Honorary Clinical Lecturer, King's College London; Specialist in Prosthodontics, West Mersea Dental Practice, Colchester and Goodleigh Dental Practice, Chelmsford (email:, Tara F Renton, PhD, MDSc, BDS, FDS RCS, FRACDS(OMS) FHEA, Professor and Honorary Consultant in Oral Surgery, King’s College London and Peter M Frost, BDS(Lond), FGDP(UK), RDT, Honorary Senior Specialist Clinical Teacher, King’s College London, London, UK.

Objective: To appreciate the contribution of intraligamentary local anaesthesia in providing anaesthesia for tooth extractions.

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