Background. The authors review four techniques for producing block and topical anesthesia that have been advocated as alternatives to conventional methods. The objective of this review is to examine the basis for each method’s application in dentistry, including scientific studies where available.
Types of Studies Reviewed. The authors reviewed both historical (1912 and 1923) and more recent (1977 to present) reports relating to specific local anesthetic delivery systems. While this article is not a comprehensive literature review, the clinical reports and double-blind scientific reports from peer-reviewed publications are specific to the various attributes of the delivery systems being described. In addition, the authors identify any claims lacking scientific validity.
Results. Several alternative local anesthetic delivery systems are clinically effective in producing local anesthesia. Potential adverse effects and complications do, however, differ from one technology to another, depending on the mechanical characteristics of the particular system. Finally, all of the alternative local anesthetic delivery systems represent additional costs when compared with those of conventional applications, and cost-effectiveness is an important factor to be considered when implementing these systems in a dental practice.
Clinical Implications. Alternative local anesthetic delivery systems may offer some advantages over conventional techniques in certain situations, although the costs may outweigh the advantages in certain cases.
