Safer dental anaesthesia in Type 2 diabetes

Dental Tribune International

Wed. 2. September 2026

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NOVI SAD, Serbia: Local anaesthesia in people with Type 2 diabetes requires particular care because of concerns surrounding cardiovascular responses to vaso-constrictors and the potential susceptibility of nerve fibres to ischaemic injury. Intraseptal anaesthesia (ISA) and periodontal ligament anaesthesia (PLA) may offer alternatives because they can be effective with small amounts of local anaesthetic and vaso-constrictor.

A recent randomised clinical study has now evaluated the two techniques regarding their efficacy and cardiovascular safety for tooth extraction in patients with controlled Type 2 diabetes, and the results suggest that ISA may offer advantages over PLA. The single-centre, single-blind randomised study included 120 adults with controlled Type 2 diabetes. Participants were randomly assigned to ISA or PLA delivered through a computer-controlled system. The researchers assessed anaesthetic success, onset, duration and field width, as well as cardiovascular parameters.

Both techniques produced immediate anaesthesia in successful cases, but ISA generally performed better. For extraction of maxillary lateral incisors, ISA achieved 100.0% success compared with 93.3% for PLA. For extraction of mandibular first premolars, success was 93.3% with ISA and 70.0% with PLA, although this difference was not statistically significant. ISA also produced significantly longer soft-tissue anaesthesia: 60.5 minutes versus 46.2 minutes for maxillary lateral incisors, and 55.8 minutes versus 45.8 minutes for mandibular first premolars. The anaesthetic field was also significantly wider with ISA for both tooth types. Cardiovascular measurements remained broadly stable for both methods.

Overall, the authors concluded that both techniques were effective and safe in patients with controlled Type 2 diabetes and that ISA’s longer duration and wider anaesthetic field may make it a useful option for extraction. They recommended multicentre studies involving a broader range of dental procedures to confirm the findings.

The article, titled “Efficacy and safety of intraseptal and periodontal ligament anaesthesia for extraction of upper lateral incisors and lower first premolars in patients with Type 2 diabetes mellitus”, was published online on 24 August 2026 in Frontiers in Oral Health.