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

Abstract

BackgroundLocal 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.MethodsThis 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.ResultsA 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).ConclusionCC-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 registrationThe study was prospectively registered in ClinicalTrials.gov with the identifier: NCT04739735 on 26th of January 2021,https://clinicaltrials.gov/ct2/show/NCT04739735.

Developmental Disturbance in Premolars After Intraligamental Anesthesia Using Computer-Controlled Local Anesthesia Delivery System: An-Eight-Years Follow-Up Study in Children

“…High-pressure injections using a traditional syringe may harm the underlying permanent dental buds when anesthetizing the primary molars [ 8 ]. If ILA is administered with a high-pressure syringe, the periodontal tissue may be damaged, which prolongs postoperative pain [ 3 , 14 ].…”

“…This study helps pediatric dentists use the ILA with CCLADS without having to consider or worry about the consequences of this technique on the dental bud of the permanent successor. Contrary to the high pressure applied by conventional ILA, slow administration of the local anesthetic solution by CCLADS is predicted to not harm the periodontal apparatus [ 14 ].…”

“…However, there was no significant association between the type of anesthesia administered and the development of a post-treatment abscess, the need for retreatment or post-treatment extraction, and the development of clinical defects in the permanent successor. A longitudinal study assessed the association between dental caries in primary molars and enamel defects in premolars and found that permanent teeth were more likely to have a demarcated defect or any defect if there had been caries in the primary precursor by the age of five [ 14 ].…”

“…The demarcated white opacity found in the permanent tooth of the second patient, in which the related primary tooth had a dental abscess, the previously mentioned defect could be related to damage caused by the dental abscess. Previous studies have found that pulp necrosis of primary teeth and periapical infection can have consequences for successors, including white or yellow opacity and enamel hypoplasia [ 14 , 15 ]. It is worth noting that both patients were seven years old at the time of anesthesia administration, which corresponds to the dental age after completion of the mandibular premolar crown [ 16 ].…”

Use of computerized anesthesia in children's anxiety and pain perception during dental care: protocol for a randomized clinical trial

“…In the literature, studies that have used different CCLAD can be observed. Among them are The Wand® system (Milestone Scientific) (Allen et al, 2002;Muzumdar et al, 2021), the Quicksleeper™ device (Dental HiTec, Cholet, France) (Smaïl-Faugeron et al, 2019), the Sleeper One™ device (Dental Hi Research, Society and Development, v. 12, n. 7, e7212742516, 2023 (CC BY 4.0) | ISSN 2525-3409 | DOI: http://dx.doi.org/10.33448/rsd-v12i7.42516 3 Tec, Cholet, France) (Elbay et al, 2016), Comfort Control Syringe™ (Dentsply International, York, PA, USA) (Deepak et al, 2017), Computer controlled Intraligamentary anesthesia (CC-ILA) (Helmy et al, 2022) and Morpheus™ (Meibach Tech) (Smolarek et al, 2020).…”