For a child with Duchenne muscular dystrophy and mucopolysaccharidosis who needs a single tooth extracted, which anesthesia technique is the safest choice?

In a medically complex, high-anesthesia-risk patient, using the most localized, minimal-systemic-absorption technique that still achieves adequate anesthesia for a single tooth — a PDL (intraligamentary) infiltration — is generally the safer choice, avoiding the larger volume, deeper tissue planes, and greater potential for systemic absorption/complications associated with a full nerve block.