Cartridge syringe vs computer controlled local anesthetic delivery system: Pain related behaviour over two sequential visits - a randomized controlled trial

Computer-Controlled Local Anaesthesia Delivery efficacy - a literature review

Minimising pain with effective local anaesthesia is an essential step towards improving the level of dentally anxious patients' comfort during dental treatment. It can be provided by many different techniques. One of them is using the Computer-Controlled Local Anaesthesia Delivery systems (CCLADs). This study was conducted to compare the efficacy of computerised anaesthesia with the conventional technique in terms of perceived pain. A database literature search was performed on PubMed, Cochrane Library and Google Scholar, covering up the period between 2015 and 2023. Only the studies comparing computerised anaesthesia technique with the use of conventional carpule were included. An overview of 20 relevant studies (n = 1347 subjects) was provided including pediatric patients, as well as the adults. The evaluated parameters were: pain, child's behaviour, heart rate, blood pressure, level of satisfaction, anxiety, further anaesthesia method preference, need for additional anaesthetic, as well as the duration of anaesthesia, measured by different scales, devices and questionnaires. The present literature review led the authors to the conclusion, that the use of CCLADs is significantly less painful than the traditional anaesthesia and it is a promising technique for helping patients deal with pain perception. However, it is advisable to conduct further research on the use of CCLAD.

Efficacy of computer-controlled local anesthesia delivery system on pain in dental anesthesia: a systematic review of randomized clinical trials

Computer-controlled local anesthesia delivery (CCLAD) is an innovative electronic injection device that represents a cutting-edge approach to dental anesthesia. This system is promising for painless anesthesia using controlled anesthetic injections. This review aimed to compare the discomfort experienced by patients during local anesthesia using a traditional syringe and the CCLAD system and evaluate the potential of the CCLAD system as a painless dental anesthesia solution. The inclusion criteria for this study were based on the recommendations of the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines. The study population, including children and adults, underwent dental anesthesia using the CCLAD system, ensuring a comprehensive and representative sample that instills confidence in the validity of the results. Fourteen clinical trials were included in the analysis after they fulfilled the eligibility criteria. We found that using computer-assisted anesthetic equipment not only led to a significantly lower pain perception score, but also had a profound positive impact on patient behavior. Patients using the CCLAD device exhibited more cooperative and helpful conduct, indicating the system's effectiveness in improving patient comfort and experience and reassuring the audience about its positive impact. In conclusion, using a computer-assisted anesthetic device such as the CCLAD system significantly reduced pain perception scores and improved patient behavior, making them more cooperative and helpful. These findings offer hope for pediatric dentistry and apprehensive adult patients, suggesting a more comfortable and less daunting dental experience with the CCLAD system.

Comparative Evaluation of Pain Perception with Conventional and Septoject XL Needle in 6-8-year-old Children: A Randomized Controlled Trial

Aims and background

To evaluate and compare pain perception with Septoject XL and conventional needles in 6-8 years old children.

Materials and methods

In this split-mouth randomized controlled trial, a single-blinded study, 24 children (6-8 years) were assigned at random to receive the local anesthetic (LA) injection for treatment needs either with Septoject XL or conventional needle for the first visit in one of the quadrants, while during the second visit in a different quadrant with the other one. Children's pain levels were assessed during each visit using an objective sound eye motor (SEM) scale and subjective Wong-Baker faces rating scale (FRS).

Results

The mean objective score rating using SEM for the conventional needle (3.8 ± 2.35) and Septoject XL needle (3.3 ± 2.01) was not found to be statistically significant among the two study groups Septoject XL or conventional needle (Z score-0.996, p = 0.3). Using the Wilcoxon test, the mean subjective rating score was not found to be statistically significant among the two study groups [Z score = 0.636 and p-value = 0.524, nonsignificant (NS)]. In the gender-wise comparison of male (n =15), (6.8667 ± 91548) and female (n = 9), (6.8889 ± 1.05409), NS mean ages of male and female study participants was observed (p = 0.873).

Conclusion

Statistically, NS difference was observed in the pain perception while administration of LA using Septoject XL or conventional needle in 6-8-year-old children.

Clinical significance

This research can be useful in the selection of the gauge of the needle to be used while planning the treatment for different behavior groups.

Comparison of the effectiveness of intraligamentary anesthesia and inferior alveolar nerve block on mandibular molar teeth in pediatric patients: a randomized controlled clinical study

OBJECTIVES

The study aimed to compare the two local anesthetic techniques: inferior alveolar nerve block (IANB) and intraligamentary anesthesia (ILA) during the restorative treatment of mandibular first permanent molars in pediatric patients.

MATERIALS AND METHODS

In this randomized, controlled, cross-over, single-blind, split-mouth study, participants were divided into two groups: group 1, ILA in the first session and IANB in the second session, and group 2, IANB in the first session and ILA in the second session. The pain perception was analyzed using the visual analog scale (VAS) and Wong-Baker FACES pain rating scale (WBFPRS). Heart rate, arterial oxygen saturation (SpO₂), and postoperative complications were recorded. The data were analyzed with the Brunner-Langer model, Spearman correlation analysis, Fisher's exact t-test, chi-square, and McNemar tests.

RESULTS

Seventy-eight patients aged between 6 and 12 years were included. The session effect was not statistically significant in ILA (p = 0.762 and p = 0.411) for pain scores while it was significant in IANB (p < 0.001 for each score). There was no significant difference in the VAS, WBFPRS, heart rate, and SpO₂ between the anesthesia techniques (p = 0.454, p = 0.436, p = 0.406, p = 0.285, respectively). Postoperative complications increased in the IANB technique in the first session.

CONCLUSIONS

Intraligamentary anesthesia may be an alternative technique to IANB for the restorative treatment of mandibular first permanent molars in pediatric patients. In the first session, clinicians may choose the ILA instead of IANB.

CLINICAL RELEVANCE

In clinical procedures, administering anesthesia, which is effective, is less painful, and poses relatively low complication risk, has significant importance in sustaining children's cooperation with dental treatment.

Computer-controlled Intraligamentary local anaesthesia in extraction of mandibular primary molars: randomised controlled clinical trial

BACKGROUND

Local anesthesia (LA) poses a threat in children more than the treatment process itself, so pediatric dentists are always demanding less painful techniques. Computer-controlled Intraligamentary anaesthesia (CC-ILA) is designed to reduce injection pain and side effects of conventional techniques. The present study aims to assess the pain experience using Computer-controlled Intraligamentary anaesthesia (CC-ILA) during injection and its effectiveness in controlling pain during extraction of mandibular primary molars in pediatric patients.

METHODS

This randomized controlled clinical trial includes 50 healthy cooperative children, aged 5-7 years with mandibular primary molars indicated for extraction. They were randomly allocated to two groups according to LA technique: test group received CC-ILA and control group received Inferior alveolar nerve block (IANB). Pain was measured during injection and extraction: physiologically using Heart rate (HR), subjectively using Face-Pain-Scale (FPS), and objectively using Sound-Eye-Motor scale (SEM). Patients were recalled after 24-h to record lip-biting events. Data was collected and statistically analysed.

RESULTS

A total of 50 children (29 females and 21 males) with mean age 6.10 ± 0.76 participated in the study. There were significantly lower scores in the heart rate in the CC-ILA group during injection (p = 0.04), but no significant difference was recorded between the two groups during extraction (p = 0.17). The SEM and FPS showed significant lower scores in the CC-ILA group during injection (p < 0.0001, p < 0.0001) and extraction (p < 0.0001, p = 0.01) respectively. No children in CC-ILA group reported lip-biting after 24-h compared to 32% in IANB (p < 0.0001).

CONCLUSION

CC-ILA provides significantly less painful injections than conventional techniques and has proved to be as effective as IANB during extraction of mandibular primary molars. An important advantage of this technique was the complete absence of any lip/cheek biting events. Trial registration The study was prospectively registered in ClinicalTrials.gov with the identifier: NCT04739735 on 26th of January 2021, https://clinicaltrials.gov/ct2/show/NCT04739735 .

Assessment of Knowledge, Attitude, and Practices Regarding Advanced Local Anesthetic Techniques among Students Attending a Private Dental College in Navi Mumbai, India: A Cross-sectional Study

Aim and objective

Local anesthesia (LA) administration is an anxiety-provoking phenomenon in patients. Several alternative and advanced techniques make LA administration patient-friendly. This study assesses the knowledge, attitude, and practices of these advances, creating awareness and encouraging further studies and innovations to make these techniques more accessible, available, and economical to be utilized in the Indian population for controlling pain by targeting the budding dentists who actively imbibe and are abreast with the current state of affairs.

Methods and materials

A descriptive cross-sectional questionnaire-based study was conducted among the undergraduate and postgraduate students of a private college in Navi Mumbai. The self-administered questionnaire contained 13 questions. The data was analyzed using Statistical Package for Social Sciences (SPSS) version 17 software and a Chi-square test were applied.

Results

A majority of the respondents were unaware of the alternative techniques (59.4%) with a significant difference between undergraduates and postgraduates. 95.7% thought conventional methods caused dental anxiety and 55.1% thought alternatives would be better. The pain management techniques currently used were mostly reassurance and distraction (84.2%) and Topical anesthesia (74.9%). Only 9.6% had actually practiced these techniques, the reason for inexperience being inadequate knowledge. Out of those who had used these techniques, 47.82% saw positive results with patients experiencing less pain.

Conclusion

Knowledge of advanced local anesthetic techniques in the dental fraternity is necessary to enhance practice and provide the best care to the patients. Its inclusion in the curriculum with adequate practical training shall ensure its use efficiently.

Clinical significance

Today dentistry is propelling toward minimally invasive, painless, and patient-friendly procedures. The incorporation of advanced LA techniques to help achieve this goal begin with assessing its awareness among future dentists which would help make them accessible and affordable and contribute toward providing patients a holistic treatment.

How to cite this article

Bhanushali NV, Atre SY, Kumar V, et al. Assessment of Knowledge, Attitude, and Practices regarding Advanced Local Anesthetic Techniques among Students Attending a Private Dental College in Navi Mumbai, India: A Cross-sectional Study. Int J Clin Pediatr Dent 2022;15(1):94-98.

Behavioral Strategies to Minimize Procedural Distress During In-Office Pediatric Tympanostomy Tube Placement Without Sedation or Restraint

The purpose of this study was to evaluate behavioral strategies to minimize procedural distress associated with in-office tympanostomy tube placement for children without general anesthesia, sedation, or papoose-board restraints. 120 6-month- to 4-year-olds and 102 5- to 12-year-olds were treated at 16 otolaryngology practices. Mean age of children was 4.7 years old (SD = 3.18 years), with more boys (58.1%) than girls (41.9%). The cohort included 14% Hispanic or Latinx, 84.2% White, 12.6% Black, 1.8% Asian and 4.1% ‘Other’ race and ethnicity classifications. The in-office tube placement procedure included local anesthesia via lidocaine/epinephrine iontophoresis and tube placement using an integrated and automated myringotomy and tube delivery system. Behavioral strategies were used to minimize procedural distress. Anxiolytics, sedation, or papoose board were not used. Pain was measured via the faces pain scale-revised (FPS-R) self-reported by the children ages 5 through 12 years. Independent coders supervised by a psychologist completed the face, legs, activity, cry, consolability (FLACC) behavior observational rating scale to quantify children’s distress. Mean FPS-R score for tube placement was 3.30, in the “mild’ pain range, and decreased to 1.69 at 5-min post-procedure. Mean tube placement FLACC score was 4.0 (out of a maximum score of 10) for children ages 6 months to 4 years and was 0.4 for children age 5–12 years. Mean FLACC score 3-min post-tube placement was 1.3 for children ages 6 months to 4 years and was 0.2 for children age 5–12 years. FLACC scores were inversely correlated with age, with older children displaying lower distress. The iontophoresis, tube delivery system and behavioral program were associated with generally low behavioral distress. These data suggest that pediatric tympanostomy and tube placement can be achieved in the outpatient setting without anxiolytics, sedatives, or mechanical restraints.

The influence of distinct techniques of local dental anesthesia in 9- to 12-year-old children: randomized clinical trial on pain and anxiety

OBJECTIVES

To evaluate pain, disruptive behavior, and anxiety in children undergoing different local dental anesthetic techniques.

METHODS

This randomized/parallel clinical trial analyzed three groups of patients (9-12 years old) (n = 35) who received infiltrative anesthesia using conventional (CA), vibrational (VBA), and computer-controlled techniques (CCLAD). The outcomes were pain self-perception (Wong-Baker Faces Pain Rating Scale (WBF); Numerical Ranting Scale (NRS)), disruptive behavior (Face, Legg, Activity, Crying, Consolability Scale (FLACC)), anxiety (Corah's Dental Anxiety Scale; modified Venham Picture test (VPTm)), and physiological parameters (systolic (SBP)/diastolic pressure (DBP); heart rate (HR); oxygen saturation (SpO2); respiratory rate (RR)). Statistical analysis was accomplished using Kruskall-Wallis test and ANOVA for repeated measures (α = 0.05).

RESULTS

Dental anxiety levels at the baseline were similar for all patients. CA promoted less pain than VBA in WBF (p = 0.018) and NRS (p = 0.006) and CCLAD in WBF (p = 0.029). There were no differences in disruptive behavior (FLACC p = 0.573), anxiety (VPTm p = 0.474), blood pressure (SBP p = 0.954; DBP p = 0.899), heart rate (p = 0.726), oxygen saturation (p = 0.477), and respiratory rate (p = 0.930) between anesthetic techniques.

CONCLUSION

Conventional technique resulted in less pain perception for dental local anesthesia.

CLINICAL RELEVANCE

Conventional technique reduces the self-reported pain in children 9-12 years old, and therefore, the use of additional devices or different anesthetic techniques is not justified.

Patient evaluations after local anesthesia with a computer-assisted method and a conventional syringe before and after reflection time: A prospective randomized controlled trial

Objectives

This prospective randomized controlled trial aimed to evaluate and compare patient response to a conventional syringe and a computer-controlled local anesthetic delivery system (CCLAD) both immediately and after reflection time, including the impact of anesthesia duration.

Methods

Twenty adult patients (10 men and 10 women) with at least two tooth-neck defects each in different quadrants were treated with local buccal infiltration anesthesia. Using split-mouth design, one quadrant was anesthetized using a conventional syringe, the other with CCLAD. The time elapsed between time of injection and time of disappearance of numbness was recorded. Patients were asked to mark on a Visual Analog Scale their visual impression of the device regarding anxiety-inducement, their sensation of mucosal puncture, pain during administration, and pain perception during treatment for the two different methods as well as future preference immediately after treatment and after reflection time.

Results

The level of anxiety-inducement and pain during administration were ranked three times higher with the conventional syringe (35.95%-11.85%, p < 0.001 and 21.3%-7.7%, p = 0.005, respectively). There was no difference in mean sensation of mucosal puncture, nor a statistically significant correlation between duration of administration and time until disappearance of numbness. Once anesthesia was administered, no pain during treatment was detected using either method. Patients' preference of methods changed significantly with time in favor of CCLAD (p = 0.01).

Conclusions

The use of CCLAD increased patients' comfort visually and in terms of administration; patients' preference in favor of CCLAD increased with time.

Clinical significance

Patients' preference of CCLAD over against the conventional syringe, even more so after reflection time, can imply the preference of CCLAD for clinicians, too, in order to enhance patients' and clinicians' comfort.

"Comparative study of conventional anesthesia technique versus computerized system anesthesia: a randomized clinical trial"

OBJECTIVE

The aim of the present study was to compare in terms of pain perception the use of conventional anesthesia and a computerized system.

MATERIALS AND METHODS

Forty patients in need for extractions, dental restorative, or periodontal treatment bilaterally, were selected. Each patient served as his/her own control being subjected to two anesthesia techniques: conventional and electronically controlled anesthesia with Calaject® (Rønvig Dental MFG, Daugaard, Denmark). Each patient received both treatments in a blind way 1 week apart. The order was previously randomized. After performing the anesthesia (upper dental nerve, palatal posterior nerve, or inferior alveolar nerve), the patients evaluated their pain sensation with a visual analogue scale (VAS) (0-10). After treatment, the patients were asked about the presence of pain during the procedure. Finally, the patients selected their preference between the conventional and electronic anesthesia technique. Differences in assessment of pain's injection were analyzed using the Wilcoxon test and the Kruskal-Wallis test (α = 0.05).

RESULTS

The mean general pain experienced was 3.73 (1.55 SD) for the conventional anesthesia, and 1.95 (0.53 SD) for computerized anesthesia. Statistical differences (p < 0.05) were found. There was no difference between the treatments (p value = 0.061). Most patients did not feel any pain during the treatment. Finally, 92.5% of the patients preferred the electronic system.

CONCLUSIONS

Computerized anesthesia system produces significantly less pain compared with a conventional anesthesia syringe. Although both obtained sufficient anesthetic depth to perform treatments, the majority of patients chose electronic anesthesia as the most satisfactory.

CLINICAL RELEVANCE

Computerized anesthesia devices are valid and more comfortable alternative to conventional anesthesia.

Evaluation of pain, disruptive behaviour and anxiety in children aging 5-8 years old undergoing different modalities of local anaesthetic injection for dental treatment: a randomised clinical trial

Objective: To evaluate the influence of different local anaesthetic techniques in pain, disruptive behaviour and anxiety in children´s dental treatment.Material and methods: This was a randomised and parallel clinical trial. The sample consisted of 105 children (5-8 years old) that were divided into three groups (n = 35) according to the anaesthetic technique: conventional anaesthesia (CA); vibrational anaesthesia (VBA); computer-controlled local anaesthesia delivery (CCLAD). The outcomes were self-perception of pain (Wong-Baker Faces Pain Rating Scale - WBF; Numerical Rating Scale - NRS); disruptive behaviour (Face, Legg, Activity, Cry, Consolability Scale - FLACC); anxiety (Corah's Dental Anxiety Scale; modified Venham Picture test - VPTm) and physiological parameters (blood pressure - systolic - SBP and diastolic - DBP; heart rate - HR; oxygen saturation - SpO2; respiratory rate - RR). Data were statistically analysed with Kruskall-Wallis test and ANOVA for repeated measures with Tukey post hoc test (α = 0.05).Results: All the patients exhibited the same level of dental anxiety at baseline (Corah's Dental Anxiety Scale). There was no difference in self-perception pain, irrespective the evaluation tool used (WBF - p = .864; VAS - p = .761). No differences were detected in disruptive behaviour (FLACC - p = .318); anxiety (VPTm - p = .274); blood pressure (SBP - p = .239; DBP - p = .512); heart rate (p = .728); oxygen saturation (p = .348) and respiratory rate (p = .238) between anaesthetic techniques.Conclusion: Different anaesthetic dental local techniques do not affect the levels of pain, disruptive behaviour, anxiety and physiological parameters in children aged 5-8 years old.

Assessment of computer-controlled local anesthetic delivery system for pain control during restorative procedures: A randomized controlled trial

Background. . Local anesthesia is given to decrease pain perception during dental treatments, but it may itself be a reason for pain and aggravate the dental fear. Computer-controlled local anesthetic delivery system (CCLADS) is one of the alternatives for decreasing the patients' pain during local anesthesia. This study compared the time required for the recovery from anesthesia, pain/discomfort during injection and pain/discomfort 24 hours after administering local anesthesia with CCLADS, a standard self-aspirating syringe and a conventional disposable 2-mL syringe. Methods. The study was conducted on 90 subjects (an age group of 20-40 years), who suffered from sensitivity during cavity preparation. They were randomly divided into three groups of 30 individuals each to receive intraligamentary anesthesia (2% lignocaine with 1:80,000 adrenaline) using either of the three techniques: CCLADS, a standard self-aspirating syringe, or a conventional disposable 2-mL syringe. The onset of anesthesia, time required for recovery from anesthesia (in minutes), pain/discomfort during injection and pain/discomfort 24 hours after administering local anesthesia were recorded. Results. The time required for the onset of anesthesia and recovery from anesthesia was shorter with CCLADS (4.83±2.31 and 34.2±1.895, respectively) as compared to the standard self-aspirating group (10.83±1.90 and 43.5±7.581, respectively) and the conventional group (11.00±2.03 and 43.5±6.453, respectively) (P<0.001). The patients in the CCLADS group experienced no pain during local anesthesia administration as compared to the patients in the self-aspirating and conventional groups. The CCLADS and self-aspirating groups showed lower pain response as compared to the conventional group for pain after 24 hours. Conclusion. CCLADS can be an effective and pain-free alternative to conventional local anesthetic procedures.

Does computerized anaesthesia reduce pain during local anaesthesia in paediatric patients for dental treatment? A systematic review and meta-analysis

This systematic review and meta-analysis analysed whether pain and disruptive behaviour can be decreased by the use of computerized local dental anaesthesia (CDLA) in children. The literature was screened to select randomized clinical trials that compared computerized and conventional anaesthesia. The primary outcome was pain perception during anaesthesia; the secondary, disruptive behaviour. The risk of bias of individual papers and the quality of the evidence were evaluated. After search, 8389 records were found and 20 studies remained for the qualitative and quantitative syntheses. High heterogeneity was detected for both outcomes. For the pain perception, the overall analysis showed a standard mean difference of -0.78 (-1.31, -0.25) favouring CDLA; however, when only studies at low risk of bias were analysed (subgroup analysis), there was no difference between the two techniques [-0.12(-0.46, 0.22)]. For disruptive behaviour, no differences were detected for continuous [-0.26 (-0.68, 0.16)] or dichotomous data [0.81 (0.62, 1.06)]. The quality of evidence was judged as low for pain perception and very low for disruptive behaviour. It is concluded that there is no difference in the pain perception and disruptive behaviour in children subjected to computerized or conventional dental local anaesthesia. Notwithstanding, the quality of the available evidence is low.

Computerized intraligamental anesthesia in children: A review of clinical considerations

Pain control by means of local anesthesia is an intrinsic part of clinical practice in dentistry. Several studies evaluated intraligamental anesthesia using a computer-controlled anesthetic device in children. There is a need to provide a clinical guide for the use of computerized intraligamental anesthesia in children. Intraligamental anesthesia using a computer-controlled anesthetic device was found to cause significantly lower pain perception scores and lower pain-related behavior than traditional techniques. This device proven to be effective in restorative and pulp treatment in children; however, its effectiveness in primary teeth extraction is controversial. It is important to withdraw recommendations necessity of future studies concerning the side effects of computerized intraligamental anesthesia in children. The present study aims to review different clinical aspects of computerized intraligamental anesthesia in children along with the side-effects, type of local anesthesia and postoperative pain of this technique. This study provides dentists with a clinical guide for the use of computerized intraligamental anesthesia.

A clinical comparative study between conventional and camouflaged syringes to evaluate behavior and anxiety in 6-11-year-old children during local anesthesia administration-a novel approach

Background

The sight of dental injection can bring about severe anxiety in children. Therefore, an alternative method that is convenient, effective, and keeps the needle hidden making it child friendly is necessary. The objective of the study was to compare the efficacy of a camouflaged syringe and conventional syringe on behavior and anxiety in 6–11-year-old children during local anesthesia administration.

Methods

The study was a randomized, crossover clinical study including 30 children. Children were separated into two groups. Group 1 consisted of 15 children aged 6–8 years while group 2 consisted of 15 children aged 9–11 years. This study involved two sessions wherein all the children were injected using conventional and camouflaged syringes in separate sessions. Their behavior was assessed using the Faces, Legs, Activity, Cry, Consolability (FLACC) behavior pain scale and anxiety was assessed by measuring changes in pulse rate. Patient and operator preferences were compared.

Results

The results showed a lower mean change in pulse rate and FLACC scores in the camouflaged group, suggesting a positive behavior and lesser anxiety with camouflaged syringes than with conventional syringes.

Conclusions

The use of camouflaged syringes for anesthesia was demonstrated to be effective in improving the behavior of children and decreasing their anxiety, and is therefore recommended as an alternative to the use of conventional syringes for local anesthesia.

Single tooth anesthesia versus conventional anesthesia: a cross-over study

OBJECTIVES

The aim of the present study was to compare an electronic device, the Wand Injection System (Milestone Scientific Livingstone), with conventional anesthesia in terms of the following: pain sensation during anesthetic injection; effectiveness in achieving adequate anesthesia for a complete painless dental treatment; post-operative discomfort; and patient's anxiety toward dental treatment.

MATERIALS AND METHODS

Eighty adults from 18 to 70 years were enrolled in this cross-over study. Each patient served as his/her own control being subject to two anesthesia techniques: conventional and Single Tooth Anesthesia (STA) performed with the Wand. A split-mouth design was adopted in which each tooth undergoing conservative restorative or endodontic treatment received anesthesia with both techniques at 1-week interval. Before anesthetic administration, the patients' anxiety levels were determined. Physiological parameteres were measured before, during, and after the two injection procedures, and the Visual Analogue Scale (VAS) was used to assess pain of injection, discomfort, and anesthetic efficacy. Differences in assessment of pain's injection, discomfort, anesthetic efficacy, vital parameters (heart rate, blood pressure, and oxygen saturation), and state anxiety levels were analyzed using Student's t test (p value < 0.001).

RESULTS

The mean injection pain and post-operative discomfort ratings with Wand were lower than those with conventional syringe (p = 0.022 and p < 0.001, respectively). No differences were found in the assessment of anesthetic efficacy. Blood pressure and heart rate mean values were lower during the anesthesia performed with the Wand than with the conventional syringe (p < 0.001). The anxiety level was higher during the first appointment, independently from the device used for the injections.

CONCLUSION

The STA technique resulted in lower pain, discomfort, and lower intensity of physiological parameters.

CLINICAL RELEVANCE

Single Tooth Anesthesia could be an efficacious alternative to conventional procedures.

Computer-controlled local anesthetic delivery for painless anesthesia: a literature review

Local anesthesia is administered to reduce pain during dental treatments, but may itself cause pain and contribute to increased dental fear. Computer-controlled local anesthetic delivery (CCLAD) is one the method to reduce patient pain during local anesthesia; it is a device that slowly administers anesthetics by using a computerized device to control the injection speed. This literature review aims to provide an objective assessment of the usefulness of CCLAD for controlling pain by reviewing papers published to date that have used CCLAD.