Do Computerized Delivery Systems Promote Less Pain and Anxiety Compared to Traditional Local Anesthesia in Dental Procedures? A Systematic Review of the Literature

França, Arthur José Barbosa de; Barbirato, Davi da Silva; Vasconcellos, Ricardo José de Holanda; Pellizzer, Eduardo Piza; Moraes, Sandra Lúcia Dantas de; Vasconcelos, Belmiro Cavalcanti do Egito

doi:10.1016/j.joms.2021.11.018

Cited by 8 publications

(4 citation statements)

References 40 publications

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“…Some studies have reported lower anxiety scores with CCLAD devices, possibly because of their less threatening appearance. However, other studies have found no difference in anxiety between techniques [ 17 19 20 21 22 ]. In studies that assessed patient preferences between techniques, more tended to prefer CCLAD or vibration devices to traditional syringes for future appointments.…”

Section: Discussionmentioning

confidence: 95%

“…Multiple studies have found that needle insertion pain is significantly higher than pain experienced during anesthetic solution deposition, regardless of the technique used. This suggests that needle insertion is the most painful aspect of the injection process [ 17 ]. Vibration during needle insertion reduces pain scores compared to no vibration; however, only few studies have reached solid conclusions.…”

Section: Discussionmentioning

confidence: 99%

“…Novel devices also tend to reduce disruptive behavior in children compared with traditional syringes and are often preferred by patients. However, operator technique is an important factor [ 17 ]. This was attributed to the devices' lower pain scores and less-threatening appearance.…”

Section: Discussionmentioning

confidence: 99%

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Novel dental anesthetic and associated devices: a scoping review

Min,

Morse

2024

J Dent Anesth Pain Med

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The efficient management of pain and discomfort is essential for successful dental treatment and patient compliance. Dental professionals are commonly evaluated for their ability to perform treatment with minimal patient discomfort. Despite advancements in traditional local dental anesthesia techniques, the pain and discomfort associated with injections remain a concern. This scoping review aims to provide a comprehensive overview of the literature on novel dental anesthetics and associated devices designed to alleviate pain and discomfort during dental procedures. The Joanna Briggs Institute and the Preferred Reporting Items for Systematic reviews and Meta-Analyses Extension for Scoping Reviews guidelines were used to prepare the review. Six databases and two sources of gray literature were searched. This review analyzed 107 sources from 1994 to 2023. Local anesthesia devices were grouped into computer-controlled local anesthetic delivery (CCLAD) systems, intraosseous anesthesia (IOA), vibratory stimulation devices, and electronic dental anesthesia (EDA). CCLAD systems, particularly the Wand and Single-Tooth Anesthesia, have been the most researched, with mixed results regarding their effectiveness in reducing pain during needle insertion compared to traditional syringes. However, CCLAD systems often demonstrated efficacy in reducing pain during anesthetic deposition, especially during palatal injections. Limited studies on IOA devices have reported effective pain alleviation. Vibrating devices have shown inconsistent results in terms of pain reduction, with some studies suggesting their primary benefit is during needle insertion rather than during the administration phase. EDA devices are effective in reducing discomfort but have found limited applicability. These findings suggest that the CCLAD systems reduce injection pain and discomfort. However, the evidence for other devices is limited and inconsistent. The development and research of innovative technologies for reducing dental pain and anxiety provides opportunities for interdisciplinary collaboration and improved patient care in dental practice.

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Section: Discussionmentioning

confidence: 95%

Section: Discussionmentioning

confidence: 99%

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Novel dental anesthetic and associated devices: a scoping review

Min,

Morse

2024

J Dent Anesth Pain Med

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“…In the scientific literature, only one systematic review was found (França et al, 2022) that evaluated the effectiveness of the Morpheus® device in pediatric dental procedures. There was no significant difference between the two methods regarding pain perception, behavior during anesthesia and anxiety.…”

Section: Introductionmentioning

confidence: 99%

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

Almeida

Demarco

Cademartori

et al. 2023

RSD

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This study was designed to evaluate the use of computerized anesthesia during dental care in children. The randomized controlled trial will be carried with 92 children aged 5-11 years. Children will be randomly assigned to receive conventional anesthesia - control group, or computerized anesthesia - intervention group. To measure the child's anxiety, the Dental Subscale of the Children’s Fear Survey Schedule - CFSS-DS and the VENHAM Picture Test Modified – VPTM will be used, as well as verification of heart rate. Coping style will be evaluated with The Monitor-Blunter Dental Scale - MBDS. The child's behavior will be assessed using the Brazilian version of the VENHAM Scale and pain will be assessed using the Faces Pain Scale – Revised (FPS-R) and the Face, Legs, Activity, Cry and Consolability (FLACC). Cortisol level will be evaluated before and after the procedure, through unstimulated saliva. Dentist’s stress will be evaluated using the visual analogue scale (VAS). Given the conflicting results regarding the benefits of computerized anesthesia in the literature, it is believed that the results will help define the best strategy to reduce perception of pain, anxiety and behavior during the pediatric dentistry consultation.

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Effect of Needle Insertion Angle on Pain During Labial Infiltration Anesthesia of the Anterior Maxilla: A Randomized Clinical Trial

Moaddabi,

Molania,

Arezoumandi

et al. 2024

Clinical & Exp Dental Res

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ObjectivesThis study aimed to assess the effect of needle insertion angle on pain during labial infiltration anesthesia in the anterior maxillary region.Material and MethodsIn this parallel‐design randomized clinical trial, participants were randomly assigned to four groups for labial infiltration anesthesia of the anterior maxilla. Local anesthesia was performed with needle orientation parallel to the longitudinal axis of the tooth using a conventional syringe (Syringe‐0), needle at α angle with a conventional syringe (Syringe‐α), computer‐controlled local anesthetic delivery (CCLAD) device parallel to the longitudinal axis of the tooth (CCLAD‐0), and CCLAD at α angle (CCLAD‐α). The heart rate (HR), blood pressure (BP), and respiratory rate (RR) of participants were measured before needle insertion, immediately after needle insertion, and immediately after the injection by a vital signs monitor. The level of pain experienced by participants was quantified using a numerical rating scale (NRS). Data were analyzed by repeated‐measures ANOVA and regression models (α = 0.05).ResultsThirty‐six participants aged from 21 to 60 years, with a mean age of 35.36 years were recruited. The mean pain scores were 7.44, 4.67, 2.89, and 0.67 in groups Syringe‐0, Syringe‐α, CCLAD‐0, and CCLAD‐α, respectively (p < 0.001). Age and sex had no significant effect on pain scores (p = 0.914 and p = 0.702, respectively). The four groups had no significant difference in vital signs (p > 0.05).ConclusionsInjection at an α angle and the application of CCLAD can be used in clinical practice to decrease the pain experienced by participants during labial infiltration anesthesia of the anterior maxilla.Trial RegistrationIranian Registry of Clinical Trials: IRCT20230719058849N1.

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Do Computerized Delivery Systems Promote Less Pain and Anxiety Compared to Traditional Local Anesthesia in Dental Procedures? A Systematic Review of the Literature

Cited by 8 publications

References 40 publications

Novel dental anesthetic and associated devices: a scoping review

Novel dental anesthetic and associated devices: a scoping review

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

Effect of Needle Insertion Angle on Pain During Labial Infiltration Anesthesia of the Anterior Maxilla: A Randomized Clinical Trial

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