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

2019 ◽  
Vol 13 (4) ◽  
pp. 298-304
Author(s):  
Hrishikesh Saoji ◽  
Mohan Thomas Nainan ◽  
Naveen Nanjappa ◽  
Mahesh Ravindra Khairnar ◽  
Meeta Hishikar ◽  
...  

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.

2019 ◽  
Vol 66 (2) ◽  
pp. 69-76
Author(s):  
Meenu Mittal ◽  
Radhika Chopra ◽  
Ashok Kumar ◽  
Dhirendra Srivastava

This study was conducted to compare pain perception of intraligamentary anesthesia (ILA) using a computer-controlled local anesthetic delivery system (CCLADS) versus a conventional intraligamentary injection for extraction of primary molars. A randomized controlled trial was designed where 82 children requiring 102 primary molar extractions were given ILA of 2% lidocaine with 1:80,000 epinephrine with either the conventional method or a CCLADS. Pain during injection and extraction was assessed using the Sound, Eye, Motor (SEM) scale and heart rate recording. Faces Pain Scale–Revised (FPS) scores were self-reported by patients. The Mann-Whitney test was used for evaluation of FPS and SEM scores and Student's t test for evaluation of heart rate readings. Heart rate values during injection were found to be higher, but not statistically significantly higher (p = .077), for conventional injection versus CCLADS; however, heart rate values during extraction were significantly higher for the conventional method (p = .009). Both FPS and SEM values were found to be significantly higher for conventional ILA technique (p &lt; .05). ILA can be an effective alternative means of anesthesia for primary molar extractions, and CCLADS devices can make ILA more effective and less painful.


2015 ◽  
Vol 6 (3) ◽  
pp. 150-153
Author(s):  
Varsha Sunil Manekar

ABSTRACT Introduction Anterior middle superior alveolar (AMSA) block is a nerve block technique in conjunction with computer-controlled local anesthetic delivery (CCLAD) system. Anterior middle superior alveolar produces local anesthesia (LA) to the maxillary teeth from second premolar to the central incisor including the hard palate and corresponding soft-tissue of both buccal and palatal side, with single palatal injection. Aim To evaluate efficacy of AMSA block for extraction of maxillary first premolar. Study design In randomized single blind, split mouth clinical trial, the 14 patients received the conventional buccal-palatal (B-P) anesthesia on one side and CCLAD anesthesia AMSA for other side. The treatment consisted of bilateral extraction of maxillary first premolars for orthodontics. Pain perception ratings were obtained by using 10 point visual analog scale (VAS). Results A total of 100% cases had painless injection with CCLAD, whereas 28.57% patients had painless injection experience with conventional LA. In all cases, there was no pain during extraction on both sides. With CCLAD, buccal retraction was painful in four cases whereas palatal retraction was painful in one case. Conclusion Anterior middle superior alveolar block injected with CCLAD is better as LA technique for extraction of maxillary first premolar as compared to B-P approach. How to cite this article Manekar VS. Comparison of the Pain Perception of Conventional and Computer-controlled Anesthesia Techniques for Extraction of Maxillary First Premolar. World J Dent 2015;6(3):150-153.


2015 ◽  
Vol 39 (5) ◽  
pp. 470-474 ◽  
Author(s):  
M Mittal ◽  
A Kumar ◽  
D Srivastava ◽  
P Sharma ◽  
S Sharma

Background: Local anesthetic injection is one of the most anxiety- provoking procedure for both children and adult patients in dentistry. A computerized system for slow delivery of local anesthetic has been developed as a possible solution to reduce the pain related to the local anesthetic injection. Study design: The present study was conducted to evaluate and compare pain perception rates in pediatric patients with computerized system and traditional methods, both objectively and subjectively. Study design: It was a randomized controlled study in one hundred children aged 8-12 years in healthy physical and mental state, assessed as being cooperative, requiring extraction of maxillary primary molars. Children were divided into two groups by random sampling - Group A received buccal and palatal infiltration injection using Wand, while Group B received buccal and palatal infiltration using traditional syringe. Visual Analog scale (VAS) was used for subjective evaluation of pain perception by patient. Sound, Eye, Motor (SEM) scale was used as an objective method where sound, eye and motor reactions of patient were observed and heart rate measurement using pulse oximeter was used as the physiological parameter for objective evaluation. Results: Patients experienced significantly less pain of injection with the computerized method during palatal infiltration, while less pain was not statistically significant during buccal infiltration. Heart rate increased during both buccal and palatal infiltration in traditional and computerized local anesthesia, but difference between traditional and computerized method was not statistically significant. Conclusion: It was concluded that pain perception was significantly more during traditional palatal infiltration injection as compared to computerized palatal infiltration, while there was no difference in pain perception during buccal infiltration in both the groups


2020 ◽  
Vol 44 (6) ◽  
pp. 371-399
Author(s):  
Amaury Pozos-Guillén ◽  
Edith Loredo-Cruz ◽  
Vicente Esparza-Villalpando ◽  
Ricardo Martínez-Rider ◽  
Miguel Noyola-Frías ◽  
...  

The objective of this systematic review and meta-analysis was to compare the pain/anxiety levels associated with the anesthetic process by conventional and computer-controlled delivery systems (CCDS) in children. Four electronic databases (PubMed, EMBASE, Scopus, Google Scholar, and Dentistry & Oral Science Source/EBSCO) were comprehensively explored for eligible studies, in English or Spanish, published from January 1995 to December 2019. A systematic literature review and meta-analysis were conducted according to the PRISMA statement, including only randomized controlled clinical trials. An exhaustive search was performed in different electronic databases under a specific PICO-posed question. Relevant studies were selected based on titles and abstracts, and the full texts were retrieved. From these articles, important information was extracted. Wand demonstrated significantly lower pain than the conventional injection did. In the subgroup by pain scale analysis, the Facial Image Scale and Wong-Baker Faces Pain Scale showed a significant difference in favor of the CCDS. In general, the reviewed evidence shows that less perceived pain and anxiety occur when the local anesthetic technique is performed with a CCDS than with the traditional technique.


2020 ◽  
Vol 67 (2) ◽  
pp. 72-78
Author(s):  
Yukako Tsutsui ◽  
Katsuhisa Sunada

Articaine is a low-toxicity local anesthetic that is widely used in dentistry. Typically, epinephrine is added to prolong the duration of articaine local anesthesia; however, epinephrine exhibits adverse effects. Low-dose dexmedetomidine (DEX), an α2-adrenoreceptor agonist, reportedly prolongs local anesthesia without notable adverse cardiovascular effects. The purpose of this study was to assess whether a combination of low-dose DEX and articaine would provide a low-toxicity local anesthetic option for dental procedures without adverse cardiovascular effects. Thus, this study investigated whether DEX could prolong the local anesthetic effect of articaine using a rat model of pain. Adult male Wistar rats (N = 44; 11 per group) received a 50-μL subcutaneous injection into the plantar surface of the hind paws; injections were composed of either normal saline, 4% articaine (2 mg articaine), combined 5 μg/kg DEX and 4% articaine (1.25 μg DEX + 2 mg articaine), or combined epinephrine (1:100,000) and 4% articaine (0.9 μg epinephrine + 2 mg articaine). Subsequent acute pain perception was determined by paw withdrawal movement in response to infrared radiant heat stimulation of the plantar region. Paw withdrawal latency was tested at 5-minute intervals. Paw withdrawal latency values at 35 and 40 minutes were 3.83 ± 1.76 and 3.29 ± 1.43 seconds for articaine alone, 7.89 ± 2.72 and 7.25 ± 3.37 seconds for DEX and articaine, and 8.95 ± 2.28 and 8.17 ± 3.01 seconds for epinephrine and articaine. DEX prolonged the paw withdrawal latency of articaine for up to 35 minutes (p = .015) but not 40 minutes after injection (p = .052) when compared to articaine alone. The combination of DEX and articaine can provide effective local anesthesia for up to 35 minutes after injection.


2009 ◽  
Vol 10 (3) ◽  
pp. 43-50 ◽  
Author(s):  
Naser Asl Aminabadi ◽  
Ramin Mostofi Zadeh Farahani

Abstract Aim The aim of the study was to evaluate the effect of cooling the soft tissue of injection sites on the pain perceptions of pediatric patients during the administration of local anesthesia for routine dental procedures. Methods and Materials A total of 160 children aged 5-6 years were included in the present study. On a random basis, the subjects were allocated to the without ice pretreatment (WIP) group (topical anesthesia + counterstimulation + distraction) or the ice pretreatment (IP) group (cooling + topical anesthesia + counterstimulation + distraction). During the administration of an inferior alveolar nerve block, the children's behavior was assessed using the sound, eye, and motor (SEM) scale. The statistical analysis of data was performed based on the analysis of variance (ANOVA). Results There were no significant differences within the groups between the values of the sound, eye, and motor components for either the WIP or the IP groups (P>0.05). All three components of the SEM in the IP group were consistently lower than the WIP group (P<0.05). Moreover, the SEM value for the WIP group surpassed the IP group (P<0.05). Conclusions Cooling the site of infiltration block prior to the injection of local anesthesia significantly reduced the pain perceived during injection of local anesthetic agent in pediatric patients. Clinical Significance Pre-cooling of the soft tissues of an injection site prior to the administration of a local anesthetic can minimize the discomfort and anxiety associated with the injection procedure and facilitates the management of pediatric patients during this phase of a dental procedure. Citation Aminabadi NA, Farahani RMZ. The Effect of Pre-cooling the Injection Site on Pediatric Pain Perception during the Administration of Local Anesthesia. J Contemp Dent Pract 2009 May; (10)3:043-050.


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