Transligamentary anesthesia: a review

Intraligamentary anesthesia or, as we prefer to call it, transligamentary anesthesia (TLA) is one of the more recent developments in the field of pain blockage in dentistry. This review article organizes the vast amount of information, both current as well as past, found in the dental literature. After a general historical introduction, indications for TLA use are explained. This is followed by a technical examination of the anesthesia, including the various syringes in use, the preferred injection technique, and the types and volume of anesthesia solutions used. Other aspects of TLA, including the rate of success, onset time, duration, and animal/laboratory studies, are then examined. The various advantages and disadvantages of TLA are discussed along with adverse reactions, limitations, and patient acceptance. The article closes with a look at the diagnostic possibilities of the injection as well as a call for future research on this important development.