Abstract
Pain due to administration of local anesthetics is the primary reason for patients' fear and anxiety, and various methods are used to minimize it. This study aimed to measure the degree of pain during administration of anesthesia and determine the latency time and duration of pulpal anesthesia using two anesthetic methods in the maxilla.Materials and Methods:A randomized, single-blind, split-mouth clinical trial was conducted with 41 volunteers who required class I restorations in the maxillary first molars. Local anesthesia was administered with a needleless jet injection system (experimental group) or with a carpule syringe (control) using a 30-gauge short needle. The method of anesthesia and laterality of the maxilla were randomized. A pulp electric tester measured the latency time and duration of anesthesia in the second molar. Visual analogue scale (VAS) was used to measure the degree of pain during the anesthetic method. Data were tabulated and then analyzed by a statistician. The t-test was used to analyze the differences between the groups for basal electrical stimulation. Duration of anesthesia and degree of pain were compared using the Mann-Whitney test. A 5% significance level was considered.Results:There was no statistical difference in the basal electrical stimulation threshold (mA) and degree of pain between the two methods of anesthesia (p>0.05). Latency time was 2 minutes for all subjects. The duration of pulpal anesthesia showed no statistical difference (minutes) between the two methods (p<0.001), with a longer duration for the traditional method of anesthesia (median of 40 minutes).Conclusions:The two anesthetics methods did not differ concerning the pain experienced during anesthesia. Latency lasted 2 minutes for all subjects; the traditional infiltration anesthesia resulted in a longer anesthetic duration compared with the needleless jet injection.
Highlights
Fear of pain and anxiety in patients is the most notable reason to avoid dental treatment
According to the t-test, the basal electrical stimulation threshold did not show any statistical difference between its values measured before administration of anesthesia using the two anesthetic methods (p=0.188) (Figure 2)
The Mann-Whitney test showed no statistical difference in the Visual analogue scale (VAS) pain during anesthesia (p=0.571) between the two methods
Summary
Fear of pain and anxiety in patients is the most notable reason to avoid dental treatment. Injection of local anesthetics is the most painful phase of a treatment procedure and a significant reason for its premature discontinuation. There is a relation between anxiety and fear of pain and the actual sensation of pain. Stress induced by anxiety and fear reduces a patient’s pain threshold. The sensation of pain further results in increased anxiety, and a cycle is established. The efficacy of local anesthetics and the quality standard in needle manufacturing have improved over time. The method administrating local anesthetics has practically remained unchanged. It is common to use a needle attached to a non-disposable syringe
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