Aim This study aimed to evaluate the prevalence of developmental disturbances in permanent second premolars in which their tooth buds were exposed to mandibular intraligamental anesthesia (ILA) using a computer-controlled local anesthetic delivery system (CCLAD). Materials and methods This was a longitudinal follow-up study conducted in a previous randomized clinical trial (RCT). In the previous RCT, a total of 91 children were included (61 control and 30 cases). A structured form was created that contained details about the date of birth, age, and sex at which the participants received local anesthesia and the type of local anesthesia administered (ILA using CCLADS, traditional inferior alveolar nerve block [IANB], and IANB using CCLADS). A history of post-treatment abscess, retreatment, and post-treatment extraction was documented in both groups. Descriptive statistics, including frequency and percentage, and additionally, the chi-square test and Fisher's exact test were used to compare ILA and IANB. Results Forty of the 91 children attended follow-up visits. Only two children had developmental defects: one child who received traditional IANB had a demarcated white opacity (this patient had a history of dental abscess), and another who received ILA using CCLADS showed hypoplasia on his permanent premolar. No significant association was found between the type of anesthesia and the presence of developmental defects. Conclusion The slow administration of ILA delivered by CCLADS in the primary teeth does not increase the chances of developmental disturbances or damage to the corresponding permanent tooth bud.