Comparison of anesthetic efficacy of intraosseous injection with conventional inferior alveolar nerve block in mandibular third molar surgery: a systematic review and meta-analysis

Abstract

Objective: This review focused on comparing the anesthetic efficacy of intraosseous injection and conventional inferior alveolar nerve block in mandibular third molar surgery. Study Design: Three electronic databases (PubMed, Scopus, and Web of Science) were accessed to identify randomized controlled trials comparing intraosseous injection with conventional inferior alveolar nerve block in mandibular third molar surgery. The outcome measures included onset of anesthesia, success of anesthetic technique, pain during injection of anesthesia, pain during surgery, and duration of anesthesia. Results: Four studies met the inclusion criteria and consisted of 242 mandibular third molar surgeries. No significant differences were found between the anesthetic techniques in terms of onset of anesthesia, success of anesthetic technique, pain during injection of anesthesia, and pain during surgery. However, the intraosseous technique revealed a significantly shorter duration of anesthesia than the inferior alveolar nerve block (mean difference, −56.34 minutes; 95% confidence interval, −70.72 to −41.97; P < .001). Conclusions: Despite having anesthetic efficacy similar to that of the conventional inferior alveolar nerve block, intraosseous injection has an added benefit of early recovery of sensation owing to its shorter duration of anesthesia.