[Periodontal complications with intrabony anesthesia]

Area of Science:

• Dentistry
• Anesthesiology
• Periodontology

Background:

• Intraosseous anesthesia (IOA) involves injecting anesthetic directly into cancellous bone via cortical bone.
• IOA is recognized for its rapid onset, minimal soft tissue effects, and low anesthetic dosage.
• Industry claims suggest IOA is free from periodontal necrosis and needle fracture risks.

Purpose of the Study:

• To evaluate the clinical application and periodontal risks associated with intraosseous anesthesia.
• To investigate potential long-term complications, such as necrotic bone changes, following IOA.
• To present and discuss radiographic examples of complications based on existing literature.

Main Methods:

• Clinical evaluation of intraosseous anesthesia application.
• Radiographic analysis of potential periodontal and bone complications.
• Literature review of scarce existing studies on IOA risks.

Main Results:

• Clinical reports contradict industry statements, indicating risks of periodontal tissue necrosis and needle fracture with IOA.
• These complications are underreported in current literature, with IOA often presented as low-risk.
• Radiographic evidence and case examples highlight potential for adverse outcomes.

Conclusions:

• Intraosseous anesthesia, despite its advantages, presents risks that warrant greater clinical attention and research.
• The assumption of IOA's safety regarding periodontal structures and needle integrity is challenged by practical observations.
• Systematic clinical studies are essential to comprehensively document and understand the long-term effects and potential damage from intraosseous anesthesia.