A comparative assessment of efficacy and preference between needleless device INJEX and insulin syringe for anesthetizing primary maxillary teeth in children aged 4-9 years: A split-mouth crossover randomized clinical study.

Abstract

This randomized clinical study included 46 children aged 4-9 years. The patients were digitally allotted to receive 4% articaine for extractions of primary maxillary teeth, either using needleless device INJEX or insulin syringe on each side of the maxillary arch, in two different appointments after a 1-week washout period. Pain perception was measured by the subjective (Faces Pain Scale-Revised [FPS-R]) and objective pain scores (Face, Legs, Activity, Cry, and Consolability [FLACC]) and hemodynamic parameters (heart rate and oxygen saturation) during LA administration and during extractions. After the second appointment, children were asked about their preference between needleless device INJEX and insulin syringe. On evaluating subjective pain scores with FPS-R, intergroup differences between the INJEX and insulin syringe groups were found statistically insignificant, both during LA administration (P = 0.101) and extraction (P = 0.080). However, on assessing pain objectively during extraction using FLACC, the mean pain score was less with insulin syringe (2.78) as compared to INJEX (4.72) and the difference was statistically significant (P = 0.000). There was no significant difference in patient preference between the two methods. Pain perception was minimal during local anesthesia administration using needleless device INJEX; however, its clinical efficacy during extractions was reported to be lower than insulin syringe. Managing pain in children is the most challenging task as it forms the foundation for instilling positive behavior toward dental treatment. Adequate local anesthesia (LA) is the cornerstone of pain management. However, the fear of needles, particularly in young children, can result in complete avoidance and refusal of treatment. This study aimed to evaluate and compare the efficacy and preference between needleless device INJEX and.