Conventional method versus automatic injection for infiltration anesthesia in the premolar region

  • Gholamreza Shirani Dental Research Center, Dentistry Research Institute, Tehran University of Medical Sciences, Tehran, Iran; Department of Oral and Maxillofacial Surgery, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran.
  • Mahnaz Arshad Dental Research Center, Dentistry Research Institute, Tehran University of Medical Sciences, Tehran, Iran; Department of Prosthodontics, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran.
  • Nastaran Vaziri Dental Research Center, Dentistry Research Institute, Tehran University of Medical Sciences, Tehran, Iran; Department of Prosthodontics, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran.
  • Rasoul Mehdifar Dental Research Center, Dentistry Research Institute, Tehran University of Medical Sciences, Tehran, Iran; Department of Prosthodontics, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran.
Keywords: Pain scores, Automatic injection, Infiltration anesthesia

Abstract

Introduction: Pain control by local anesthesia plays a critical role in success of most dental treatments. Due to the unpleasant pain experience related to the use ofthe conventional syringe injection, some computerized techniques have been developed for local anesthetic injection. Thisstudy aimed to compare the pain score following infiltration anesthesia of the maxillary premolar teeth administered by the conventional syringe and automatic. Materials and Methods: This single-bind randomized clinical trial was performed on 35 patients whose average age was 38. Requiring bilateral extraction of maxillary premolars. The patients’ dental anxiety was scored and they received infiltration anesthesia with the iCT injection SE (Dentium, South Korea) at one side and conventional syringe at the contralateral side. The pain level was recorded during needle insertion, anesthetic delivery and 5 hours after the injection using visual analog scale (VAS) and the face rating scale (FRS). The data were subjected to Wilcoxonsigned-rank test. Results: Significant differences were found between the automatic and conventional method sregarding pain scores duringneedle insertion (P<0.01) and anesthetic delivery (P<0.0001) while nosignificant differences were notedat 5 hours after the injection. Pain scores were significantly lower during supra-periosteal injections in the maxillary premolar region using iCT injection. Conclusion: Both FRS and VAS in iCT injection showed that frequency of severe pain during needle insertion and anesthetic delivery was noticeably lower than that in conventional injectionmethod but findings revealed that there was no significant difference between these two technics after 5 hours of injection. Keywords: Pain scores, Automatic injection, Infiltration anesthesia.

References

[1] Wahl MJ, Schmitt MM, Overton DA, Gordon MK.Injection pain of bupivacaine with epinephrinevs. prilocaine plain. J Am Dent Assoc. 2002Dec; 133(12):1652-6.
[2] Yenisey M. Comparison of the pain levels of computercontrolled and conventional anesthesia techniquesin prosthodontic treatment. J Appl OralSci. 2009 Sep-Oct; 17(5):414-20.
[3] Grace EG, Barnes DM, Reid BC, Flores M, GeorgeDL. Computerized local dental anesthetic systems:patient and dentist satisfaction. J Dent. 2003Jan; 31(1):9-12.
[4] Garcia-Godoy FM. A simplified local anesthetictechnic for mandibular deciduous molars.ActaOdontol Pediatr. 1982 Dec; 3(2):53-6.
[5] Saxena P, Gupta SK, Newaskar V, ChandraA. Advances in dental local anesthesia techniquesand devices: An update. Natl J MaxillofacSurg. 2013 Jan; 4(1):19-24. doi: 10.4103/0975-5950.117873.
[6] Fukayama H, Yoshikawa F, Kohase H, UminoM, Suzuki N. Efficacy of anterior and middlesuperior alveolar (AMSA) anesthesia usinga new injectionsystem: the Wand. QuintessenceInt. 2003 Jul-Aug; 34(7):537-41.
[7] Goodell GG, Gallagher FJ, Nicoll BK. Comparisonof a controlled injection pressure system witha conventional technique. Oral Surg Oral MedOral Pathol Oral Radiol Endod. 2000 Jul; 90(1):88-94.
[8] Ring ME. The history of local anesthesia. J CalifDent Assoc. 2007 Apr; 35(4):275-82.
[9] Meechan JG. Pain control in local analgesia. EurArch Paediatr Dent. 2009 Jun; 10(2):71-6.
[10]Clark TM, Yagiela JA. Advanced techniques and armamentariumfor dental local anesthesia. DentClin North Am. 2010 Oct; 54(4):757-68. doi:10.1016/j.cden.2010.06.017.
[11] Garg A. Analgesia in implant dentistry. Dent ImplantolUpdate. 2011 Jun; 22(6):41-5.
[12] Singh s, Garg A. Comparison of the pain levels ofcomputer controlled and conventional anesthesiatechniques in supra-periosteal injections: a randomizedcontrolled clinical trial. ActaOdontologicaScandinavica 2013; 71:740-743.
[13] Asarch T, Allen K, Petersen B, Beiraghi S. Efficacyof a computerized local anesthesia device in pediatricdentistry. Pediatr Dent. 1999 Nov-Dec;21(7):421-4.
[14] Koyuturk AE, Avsar A, Sumer M. Efficacy of dentalpractitioners in injection techniques: computerizeddevice and traditional syringe. Quintessence Int. 2009 Jan; 40(1):73-7.
[15] Langthasa M, Yeluri R, Jain AA, Munshi AK. Comparisonof the pain perception in children usingcomfort control syringe and a conventionalinjectiontechnique during pediatric dental procedures.J Indian Soc Pedod Prev Dent. 2012 Oct-Dec; 30(4):323-8. doi: 10.4103/0970-4388.108931.
[16]San Martin-Lopez AL, Garrigos-EsparzaLD, Torre-Delgadillo G, Gordillo-Moscoso A, Hernandez-Sierra JF, de Pozos-Guillen AJ.Clinicalcomparison of pain perception rates betweencomputerized local anesthesia and conventionalsyringe in pediatric patients. J Clin PediatrDent. 2005 Spring; 29(3):239-43.
[17]Palm AM, Kirkegaard U, Poulsen S.The wand versus traditional injection for mandibularnerve block in children and adolescents: perceivedpain and time of onset.Pediatr Dent. 2004Nov-Dec; 26(6):481-4.
[18] Sumer M, Misir F, Koyuturk AE. Comparison of the Wand with a conventional technique. Oral Surg Oral Med Oral Pathol Oral Radiol Endod.2006 Jun; 101(6): e106-9. Epub 2006 May 3.
[19]Yesilyurt C, Bulut G, Taşdemir T. Pain perceptionduring inferior alveolar injection administeredwith the Wand or conventional syringe. BrDent J. 2008 Sep 13; 205(5):E10; discussion 258-9.doi: 10.1038/sj.bdj.2008.801.
[20]Tahmassebi JF, Nikolaou M, Duggal MS.A comparisonof pain and anxiety associated with the administration of maxillary local analgesiawith Wand and conventional technique. Eur ArchPaediatr Dent. 2009 Jun; 10(2):77-82.
[21] Shah M, Shivaswamy S, Jain S, TambwekarS.A clinical comparison of pain perceptionand extent of area anesthetized by Wand (®)and a traditional syringe. J Indian Soc Periodontol.2012 Apr; 16(2): 207-12. doi: 10.4103/0972-124X.99263.
[22] Singh S, Garg A. Comparison of the pain levelsof computer controlled and conventional anesthesiatechniques in supraperiosteal injections:a randomized controlled clinical trial.ActaOdontolScand. 2013 May-Jul; 71(3-4):740-3. doi:
10.3109/00016357.2012.715200. Epub 2012 Aug20.
[23] Zilinsky I, Bar-Meir E, Zaslansky R, MendesD, Winkler E, Orenstein A. Ten commandmentsfor minimal pain during administrationof local anesthetics. J Drugs Dermatol. 2005Mar-Apr; 4(2):212-6.
[24] Primosch RE, Brooks R. Influence of anestheticflow rate delivered by the Wand Local Anesthetic System on pain response to palatal injections.Am J Dent. 2002 Feb; 15(1):15-20.
[25] Mc Grath PA. Pain control in dentistry: psychologicfactors that modify the perception of pain.Compend Contin Educ Dent. 1985 Sep; 6(8):574,576-7, 580-5.
[26] Corah NL. Development of a dental anxiety scale.J Dent Res. 1969 Jul-Aug; 48(4):596.
[27] Price DD, Mc Grath PA, Rafii A, BuckinghamB. The validation of visual analogue scales as ratioscale measures for chronic and experimentalpain. Pain. 1983 Sep; 17(1):45-56.
[28] Heft MW, Parker SR. An experimental basisfor revising the graphic rating scale for pain.Pain. 1984 Jun; 19(2):153-61.
[29] Benaim C, Froger J, Cazottes C, Gueben D, PorteM, Desnuelle C, Pelissier JY. Use of the FacesPain Scale by left and right hemispheric strokepatients.Pain. 2007 Mar; 128(1-2):52-8. Epub 2006Oct 5.
Published
2018-04-22
How to Cite
1.
Shirani G, Arshad M, Vaziri N, Mehdifar R. Conventional method versus automatic injection for infiltration anesthesia in the premolar region. jcr. 5(1):19-6.
Section
Original Article(s)