Assessment of the effectiveness of intraosseous anaesthesia during restorative procedures on teeth affected by molar incisor hypomineralisation in children.

PURPOSE: Molar incisor hypomineralisation (MIH) is an enamel defect that impacts at least one first permanent molar, frequently involving the incisors. Managing MIH-affected teeth is challenging due to inflammation, sensitivity, rapid caries development and difficulty achieving anaesthesia. Local anaesthesia, linked to pain, is a key factor in fear and discomfort in children. The objective of this study was to evaluate and compare the effectiveness of intraosseous (IO) and intraligamentary anaesthesia in providing analgesia during restorative procedures for MIH-affected molars in children aged 6 to 14 years. METHODS: In a split-mouth study, 25 healthy patients (aged 6-14 years) with confirmed MIH on the lower first permanent molars participated. Each child underwent two restorative procedures: one with intraligamentary anaesthesia on the first visit, and second with intraosseous anaesthesia using the QuickSleeper™ computerised system on the subsequent visit. The teeth were restored with glass ionomer fillings in both sessions. Parameters evaluated included onset time, pain during administration, repeat anaesthesia needs, anaesthetic efficacy, heart rate and postoperative complications. Statistical analysis was performed. RESULTS: IO anaesthesia provided significantly faster onset and lower pain during administration compared to intraligamentary anaesthesia. Heart rate was significantly lower during restorative procedures with IO anaesthesia. Intraligamentary anaesthesia achieved profound analgesia in 24% of MIH-affected teeth, whilst IO anaesthesia achieved profound analgesia in 80% of cases. CONCLUSION: IO anaesthesia demonstrated superior efficacy and less pain compared to intraligamentary anaesthesia for restorative procedures on MIH-affected first permanent mandibular molars in children, with faster onset and higher success in achieving profound anaesthesia. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT07457450; February 11th, 2026, retrospectively registered.