For the treatment of mandibular first permanent molars in pediatric patients, intraligamentary anesthesia can be used as an alternative primary anesthesia to inferior alveolar nerve block.

A randomized controlled clinical trial sought to compare inferior alveolar nerve block (IANB) and intraligamentary anesthesia (ILA) during the restorative treatment of pediatric's mandibular first permanent molars.

Participants were split into two groups: Group 1, which received ILA instruction in the first session and IANB instruction in the second, and Group 2, which received IANB instruction in the first session and ILA instruction in the second. Using the visual analogue scale (VAS) and Wong-Baker FACES pain rating scale (WBFPRS), the perception of pain was examined.

Postoperative problems, heart rate, and arterial oxygen saturation (saturation of peripheral oxygen [SpO2]) were noted. The Brunner-Langer model, Spearman correlation analysis, Fisher's exact t-test, chi-square, and McNemar tests were used to examine the data.

In this single-blind, split-mouth, cross-over study, 78 patients (6-12 years of age) were incorporated. The impact of session was not clinically meaningful for pain scores in ILA. However, it was significant in IANB. Between the anesthetic methods, no major variation in VAS, WBFPRS, heart rate, and SpO2 was noted. In the first session of the IANB method, postoperative problems elevated.

ILA can be used as an alternative primary anesthesia to IANB in the restorative treatment of mandibular first permanent molars in pediatrics. In the first session, doctors may select ILA instead of IANB.