Comparison of Analgesic Effect of Inferior Alveolar Nerve Block and Lidocaine Infiltration in Posterior Mandibular Implant Placement: A Split-Mouth Randomized Clinical Trial.

Background: Implantology is a widely accepted treatment, as it restores aesthetics and function, and is the preferred option for replacing missing teeth. In mandibular implant surgery, the Inferior Alveolar Nerve Block (IANB) is the most common anesthetic technique, as it eliminates sensation on one side of the jaw, floor of the mouth, teeth, tongue, and gums. However, its high failure rate is due to the technical difficulty of the injection procedure. Additionally, deep anesthesia from IANB carries risks such as damage to the mandibular canal. In contrast, infiltration anesthesia desensitizes the inferior alveolar nerve locally, allowing patients to perceive pain and alert the dentist if the implant approaches the nerve. We aimed to compare the effects of IANB and local infiltration anesthesia for posterior mandibular implant surgery. Methods: This prospective, randomized, double-blind clinical trial followed a split-mouth design, involving 29 patients undergoing bilateral implant surgery in the posterior mandible within a single session. On one side, IANB anesthesia was used, and on the other, infiltration was administered. Pain was assessed using the Visual Analog Scale (VAS). Results: All 58 implants were analyzed. The VAS scores during surgery were significantly higher for the infiltration technique (P = 0.03). However, no significant difference in pain was observed 24 hours post-surgery (P = 0.223). Conclusion: Both IANB and infiltration anesthesia are effective for mandibular implant surgery, but IANB offers more reliable pain control, making it preferable for complex cases, while infiltration is suitable for less invasive procedures.