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Nogueira APA, Ferreira MC, Maia CDCR, Gonçalves BLL, Filho EM, Costa CP, Gavini G, Grazziotin-Soares R, Carvalho CN. Efficacy of articaine anesthesia with needle-free/Comfort-in method and conventional needle injection in dental patients with irreversible pulpitis: a randomized clinical trial. Clin Oral Investig 2024; 28:205. [PMID: 38459266 DOI: 10.1007/s00784-024-05582-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Accepted: 02/25/2024] [Indexed: 03/10/2024]
Abstract
OBJECTIVE To assess the anesthetic efficacy of articaine with the needle-free/Comfort-in™ method compared to the conventional needle method. To assess pain during anesthesia application, onset of anesthesia and patient`s self-reported quality of life-related to oral health after the dental emergency appointment. MATERIALS AND METHODS This parallel, randomized clinical trial was conducted by a single operator/dentist in the state of Maranhao, northeast of Brazil. Included participants were adult dental patients with one molar (maxillary) or premolar (maxillary or mandibular) tooth diagnosed with symptomatic irreversible pulpitis. The primary outcome was the anesthetic efficacy, measured using a combination of electrical and cold pulp tests (cold + EPT) and the Numerical Rating Scale (NRS). Secondary outcomes were pain during anesthesia application, onset of anesthesia, and patient`s quality-of-life (measured with the OHIP-14). RESULTS 62 patients were randomized in the anesthesia needle-free group and Comfort-in group (34.26 ± 10.786 × 33.29 ± 8.399 years old, respectively). The group of patients in the Comfort-in group had 71.0% success. Patients from the Comfort-in group reported statistically lower pain during the anesthesia application than patients from the conventional group (2.13 ± 2.172 × 6.03 ± 3.146 NRS scores, respectively) as well as immediately after the anesthetic procedure. Patients self-reported negative impact in quality of life was similar between groups before (p > 0.05) and after (p > 0.05) the dental emergency. CONCLUSIONS Comfort-in™ had similar efficacy to the conventional needle method. CLINICAL RELEVANCE This trial showed that it is possible to anesthetize patients with tooth pulpits without using needles to provide comfort mainly to anxious patients.
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Affiliation(s)
- Amanda Palmeira Arruda Nogueira
- Dentistry Postgraduate Program, University Ceuma, R. Josué Montello, 1, Renascença II, São Luís, Maranhão, 65075-120, Brazil
- Dentistry Postgraduate Program, Dentistry Biomaterials Laboratory (Biomma), School of Dentistry, Federal University of Maranhão (UFMA), Av. dos Portugueses, 1996, São Luís, 65080-805, Brazil
| | - Meire Coelho Ferreira
- Dentistry Postgraduate Program, University Ceuma, R. Josué Montello, 1, Renascença II, São Luís, Maranhão, 65075-120, Brazil
| | | | - Bruna Laís Lins Gonçalves
- Dentistry Postgraduate Program, University Ceuma, R. Josué Montello, 1, Renascença II, São Luís, Maranhão, 65075-120, Brazil
| | - Etevaldo Maia Filho
- Dentistry Postgraduate Program, University Ceuma, R. Josué Montello, 1, Renascença II, São Luís, Maranhão, 65075-120, Brazil
| | - Cyrene Piazera Costa
- Dentistry Postgraduate Program, University Ceuma, R. Josué Montello, 1, Renascença II, São Luís, Maranhão, 65075-120, Brazil
| | - Giulio Gavini
- Department of Restorative Dentistry, School of Dentistry, University of São Paulo (FOUSP), Av. Lineu Prestes, 2227, São Paulo, 05508-000, Brazil
| | - Renata Grazziotin-Soares
- Division of Endodontics, Dept. of Oral Biological and Medical Sciences, Faculty of Dentistry University of British Columbia UBC, Vancouver, Canada
| | - Ceci Nunes Carvalho
- Dentistry Postgraduate Program, University Ceuma, R. Josué Montello, 1, Renascença II, São Luís, Maranhão, 65075-120, Brazil.
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Alameeri AA, AlShamsi HA, Murad A, Alhammadi MM, Alketbi MH, AlHamwi A, Rawi NHA, Kawas SA, Mohammed MM, Shetty SR. The feasibility of needleless jet injection versus conventional needle local anesthesia during dental procedures: a systematic review. J Korean Assoc Oral Maxillofac Surg 2022; 48:331-341. [PMID: 36579904 PMCID: PMC9807371 DOI: 10.5125/jkaoms.2022.48.6.331] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2022] [Revised: 08/04/2022] [Accepted: 08/08/2022] [Indexed: 12/30/2022] Open
Abstract
This systematic review evaluates current evidence regarding the feasibility of using needleless jet injection instead of a conventional local anesthetic needle. EBSCO, ProQuest, PubMed, and Scopus databases were used to identify relevant literature published in English from 2005 to 2020. Ten studies were selected. Five of them were randomized clinical trials, 3 case-control studies, and 2 equivalence trials. Using the Critical Appraisal Skills Program checklist, 6 studies scored between 67% and 100%, and 4 studies scored between 34% and 66%. According to Jadad's scale, 2 studies were considered strong, and 8 studies were considered moderate in quality. The results of the 10 studies showed differences in patient preference for needleless jet injection. Needleless injection technique has been found to be particularly useful in uncooperative patients with anxiety and needle phobia. Needleless jet injection is not technique sensitive. However, with needleless jet anesthesia, most treatments require additional anesthesia. Conventional needle anesthesia is less costly, has a longer duration of action, and has better pain control during dental extraction. Needleless jet anesthesia has been shown to be moderately accepted by patients with a fear of needles, has a faster onset of action, and is an efficient alternative to conventional infiltration anesthesia technique.
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Affiliation(s)
- Alreem Ahmed Alameeri
- Department of Oral and Craniofacial Health Sciences, College of Dental Medicine, University of Sharjah, Sharjah, United Arab Emirates
| | - Hessa AlFandi AlShamsi
- Department of Oral and Craniofacial Health Sciences, College of Dental Medicine, University of Sharjah, Sharjah, United Arab Emirates
| | - Amel Murad
- Department of Oral and Craniofacial Health Sciences, College of Dental Medicine, University of Sharjah, Sharjah, United Arab Emirates
| | - Mariam Mahmoud Alhammadi
- Department of Oral and Craniofacial Health Sciences, College of Dental Medicine, University of Sharjah, Sharjah, United Arab Emirates
| | - Meznah Hamad Alketbi
- Department of Oral and Craniofacial Health Sciences, College of Dental Medicine, University of Sharjah, Sharjah, United Arab Emirates
| | - Arwa AlHamwi
- Department of Oral and Craniofacial Health Sciences, College of Dental Medicine, University of Sharjah, Sharjah, United Arab Emirates
| | - Natheer Hashim Al Rawi
- Department of Oral and Craniofacial Health Sciences, College of Dental Medicine, University of Sharjah, Sharjah, United Arab Emirates
| | - Sausan Al Kawas
- Department of Oral and Craniofacial Health Sciences, College of Dental Medicine, University of Sharjah, Sharjah, United Arab Emirates
| | - Marwan Mansoor Mohammed
- Department of Oral and Craniofacial Health Sciences, College of Dental Medicine, University of Sharjah, Sharjah, United Arab Emirates
| | - Shishir Ram Shetty
- Department of Oral and Craniofacial Health Sciences, College of Dental Medicine, University of Sharjah, Sharjah, United Arab Emirates,Shishir Ram Shetty, Department of Oral and Craniofacial Health Sciences, College of Dental Medicine, University of Sharjah, 27272 Sharjah, United Arab Emirates, TEL: +971-556491740, E-mail: , ORCID: https://orcid.org/0000-0002-8097-6024
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Shankar P, Chellathurai BNK, Kumar SA, Mahendra J, Mugri MH, Sayed M, Almagbol M, Al Wadei MHD, Vijayalakshmi R, Ambalavanan N, Raj AT, Patil S. A Comparison in Patient Comfort Using Conventional Syringe and Needleless Jet Anesthesia Technique in Periodontal Surgery—A Split-Mouth Randomized Clinical Trial. Medicina (B Aires) 2022; 58:medicina58020278. [PMID: 35208601 PMCID: PMC8880158 DOI: 10.3390/medicina58020278] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2022] [Revised: 01/29/2022] [Accepted: 02/11/2022] [Indexed: 11/16/2022] Open
Abstract
Background and Objectives: Periodontal surgery requires local anesthetic coverage to alleviate patient discomfort. Needles and injections can engender feelings of fear and anxiety in individuals. This study aimed to assess the level of comfort and anxiety in patients during the administration of local anesthesia using needleless jet anesthesia (JA) when compared to a conventional syringe (CS) in periodontal surgery. Method and Materials: 60 sites were designated for injection in a split-mouth design in 30 subjects who required periodontal surgery. Local anesthesia was administered in two appointments scheduled one week apart using either a JA system or a CS. The Visual Analogue Scale (VAS), Verbal Rating Scale (VRS), and Beck’s anxiety inventory were used to report the pain and anxiety levels while injecting local anesthesia. Statistical analysis of the results was performed using the Shapiro–Wilks test and Paired t-test. Results: Patients reported greater comfort with JA. The VAS and VRS values were statistically significant—(p = 0.003) and (p = 0.001), respectively. Patients showed fear and were nervous about receiving a local anesthetic using a CS. A few subjects experienced lingering pain with the CS, whereas greater comfort and no lingering soreness were reported post-operatively at the site of JA administration. Conclusion: This study provides the first comprehensive assessment of using JA for periodontal surgical procedures. Lower pain scores were consistently observed with the use of jet injectors. Patients were at ease and reported lesser anxiety and greater comfort with jet injectors, making it ideally suited for providing local anesthesia in periodontal surgery.
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Affiliation(s)
- Preethi Shankar
- Department of Periodontology, Faculty of Dentistry, Meenakshi Ammal Dental College and Hospital, Alapakkam Main Road, Chennai 600095, India; (P.S.); (S.A.K.); (J.M.); (R.V.); (N.A.)
| | - Burnice Nalina Kumari Chellathurai
- Department of Periodontology, Faculty of Dentistry, Meenakshi Ammal Dental College and Hospital, Alapakkam Main Road, Chennai 600095, India; (P.S.); (S.A.K.); (J.M.); (R.V.); (N.A.)
- Correspondence: (B.N.K.C.); (S.P.)
| | - S. Ashok Kumar
- Department of Periodontology, Faculty of Dentistry, Meenakshi Ammal Dental College and Hospital, Alapakkam Main Road, Chennai 600095, India; (P.S.); (S.A.K.); (J.M.); (R.V.); (N.A.)
| | - Jaideep Mahendra
- Department of Periodontology, Faculty of Dentistry, Meenakshi Ammal Dental College and Hospital, Alapakkam Main Road, Chennai 600095, India; (P.S.); (S.A.K.); (J.M.); (R.V.); (N.A.)
| | - Maryam H. Mugri
- Department of Maxillofacial Surgery and Diagnostic Sciences, College of Dentistry, Jazan University, Jazan 45412, Saudi Arabia;
| | - Mohammed Sayed
- Department of Prosthetic Dental Sciences, College of Dentistry, Jazan University, Jazan 45412, Saudi Arabia;
| | - Mohammad Almagbol
- Department of Community and Periodontics, Faculty of Dentistry, King Khalid University, Abha 61421, Saudi Arabia;
| | | | - Rajaram Vijayalakshmi
- Department of Periodontology, Faculty of Dentistry, Meenakshi Ammal Dental College and Hospital, Alapakkam Main Road, Chennai 600095, India; (P.S.); (S.A.K.); (J.M.); (R.V.); (N.A.)
| | - Namasivayam Ambalavanan
- Department of Periodontology, Faculty of Dentistry, Meenakshi Ammal Dental College and Hospital, Alapakkam Main Road, Chennai 600095, India; (P.S.); (S.A.K.); (J.M.); (R.V.); (N.A.)
| | - A. Thirumal Raj
- Department of Oral Pathology and Microbiology, Sri Venkateswara Dental College and Hospital, Chennai 600130, India;
| | - Shankargouda Patil
- Department of Maxillofacial Surgery and Diagnostic Sciences, Division of Oral Pathology, College of Dentistry, Jazan University, Jazan 45142, Saudi Arabia
- Correspondence: (B.N.K.C.); (S.P.)
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