Non-Cochrane · intervention · PM41827245
Intraligamentary Anesthesia in Pediatric Patients: Is It an Effective Technique? A Systematic Review and Meta-Analysis.
Salerno Claudia, Cirio Silvia, Allam Aesha, et al. · Journal of clinical medicine · 2026 · PubMed · doi:10.3390/jcm15051828
Findings
Population Children and adolescents younger than 18 years undergoing dental treatment (mainly primary molars)
1 finding
| Intraligamentary anesthesia (ILA) | Inferior alveolar nerve block (IANB) | Pain perception during injection (VAS) During injection · Pediatric dental treatment (pulpotomy, extraction, restorations) | SMD -0.11 [-0.90, 0.69] GRADE not reported 3 studies · 211 participants |
Included primary studies 13
Open in Studies| Study | Year | Also included by | Outcomes it informs here | Trial data |
|---|---|---|---|---|
| Alamoudi 2016 The effectiveness of computerized anesthesia in primary mandibular molar pulpotomy: A randomized controlled trial. PMID:26504907 | 2016 | this review only | not stated | not extracted yet |
| Baghlaf 2015 The pain-related behavior and pain perception associated with computerized anesthesia in pulpotomies of mandibular primary molars: A… PMID:26287025 | 2015 | this review only | not stated | not extracted yet |
| Baghlaf 2023 Developmental Disturbance in Premolars After Intraligamental Anesthesia Using Computer-Controlled Local Anesthesia Delivery System:… PMID:38259367 | 2023 | this review only | not stated | not extracted yet |
| Elbay 2016 Intraligamentary and Supraperiosteal Anesthesia Efficacy Using a Computer Controlled Delivery System in Mandibular Molars. PMID:27472565 | 2016 | this review only | not stated | not extracted yet |
| Haghgoo 2015 Comparison of periodontal ligament injection and inferior alveolar nerve block in mandibular primary molars pulpotomy: a randomized… PMID:26028895 | 2015 | this review only | not stated | not extracted yet |
| Helmy 2022 Computer-controlled Intraligamentary local anaesthesia in extraction of mandibular primary molars: randomised controlled clinical trial. PMID:35596166 | 2022 | this review only | not stated | not extracted yet |
| Mittal 2019 Comparison of Pain Perception Using Conventional Versus Computer-Controlled Intraligamentary Local Anesthetic Injection for Extraction of… PMID:31184941 | 2019 | this review only | not stated | not extracted yet |
| Orafi 2023 Efficacy of inferior alveolar nerve block and intraligamentary anesthesia in the extraction of primary mandibular molars: A randomized… PMID:37520609 | 2023 | this review only | Pain perception during injection (VAS) | not extracted yet |
| Oztas 2005 The wand in pulp therapy: an alternative to inferior alveolar nerve block. PMID:15997937 | 2005 | this review only | not stated | not extracted yet |
| Patini 2018 Dental anaesthesia for children - effects of a computer-controlled delivery system on pain and heart rate: a randomised clinical trial. PMID:30143396 | 2018 | this review only | not stated | not extracted yet |
| Perugia 2017 Comparison of single tooth anaesthesia by computer-controlled local anaesthetic delivery system (C-CLADS) with a supraperiosteal… PMID:29254346 | 2017 | this review only | not stated | not extracted yet |
| Tekin 2012 matched by author and year (probable) | NR | this review only | Pain perception during injection (VAS) | not extracted yet |
| Yilmaz 2023 Comparison of the effectiveness of intraligamentary anesthesia and inferior alveolar nerve block on mandibular molar teeth in pediatric… PMID:36773129 | 2023 | this review only | Pain perception during injection (VAS) | not extracted yet |
Review question
| Element | Planned (methods) | Found (results) |
|---|---|---|
| Population | Children and adolescents younger than 18 years undergoing any dental treatment | Children aged 3 to 13 years, 859 enrolled (mostly primary mandibular molars) (n=13 studies) |
| Intervention | ILA delivered by conventional technique or computer-controlled delivery system | ILA and computer-controlled ILA (CC-ILA) |
| Comparison | Conventional local anesthesia (e.g., IANB, SPA) by traditional or computer-controlled delivery; alternative ILA delivery techniques | IANB, SPA, CC-SPA, CC-IANB, conventional ILA vs CC-ILA |
| Outcomes | Primary: pain/discomfort perception; secondary: anxiety, need for additional anesthesia, postoperative complications | Pain perception (VAS, ECS, VNRS, FPS), physiological parameters, behavior, patient preference, additional anesthesia, lip biting, hematoma, postoperative pain, developmental enamel defects |
| Study designs | RCTs | RCTs (n=13; 2 crossover, 4 split-mouth) |
| Timing | Not specified | Injection phase and procedure; 8-year follow-up in one study |
AMSTAR 2 items
Two independent extractors rated each item. Their ratings are shown side by side because they have not been reconciled yet. The overall rating follows Shea et al. 2017: one critical flaw gives Low, more than one gives Critically Low.
| Item | Extractor A | Extractor B | Agree |
|---|---|---|---|
| 1Research question includes PICO components | Yes | Yes | yes |
| 2Protocol established before the reviewcritical | No | Partial Yes | no |
| 3Choice of study designs explained | No | No | yes |
| 4Comprehensive literature searchcritical | Partial Yes | Partial Yes | yes |
| 5Study selection in duplicate | Yes | Yes | yes |
| 6Data extraction in duplicate | Yes | Yes | yes |
| 7List of excluded studies with reasonscritical | Yes | Yes | yes |
| 8Included studies described in detail | Partial Yes | Partial Yes | yes |
| 9Risk of bias assessed satisfactorilycritical | RCT: Yes · NRSI: N/A | RCT: Yes | no |
| 10Funding of included studies reported | Yes | Yes | yes |
| 11Appropriate meta-analysis methodscritical | NRSI: N/A · RCT: Yes | RCT: Yes · NRSI: N/A | no |
| 12Impact of risk of bias on the pooled results | Yes | Yes | yes |
| 13Risk of bias accounted for in interpretationcritical | Yes | Yes | yes |
| 14Heterogeneity explained | Yes | Yes | yes |
| 15Publication bias investigatedcritical | Yes | Yes | yes |
| 16Conflicts of interest reported | Yes | Yes | yes |
| Overall | Low | High | no |