Dentapen versus traditional syringe infiltration - which LA technique is preferred by patients?

Abstract

Design Single-blind randomised cross-over trial.Intervention The study compared solution deposition pain of a maxillary lateral incisor infiltration between a computer-controlled local anaesthesia delivery device (Dentapen) and traditional syringe. The Dentapen was given with a slow flow rate of 1.8 mL/162 sec and ramp-up mode, and the traditional syringe infiltration was delivered at a flow rate of 1.8 ml/60 sec. Patients were randomly assigned to a sequence to receive both interventions at two separate appointments, with each participant acting as their own control. Patients rated the pain of each intervention using a Heft-Parker visual analogue scale and completed a preference survey at the conclusion of the second appointment.Case selection A total of 130 adult patients with ASA I or II were included in the study. Criteria for exclusion were patients under 18 years of age or older than 65, allergies to local anaesthetics or sulphites, pregnant or nursing, history of significant medical conditions (ASA III or higher), taking any medications that may affect pain assessment, active pathosis at the injection site, or inability to give informed consent.Data analysis Differences in pain of solution deposition for the Dentapen and traditional infiltration techniques were analysed using paired t-tests and odds ratios. Interactions between study groups, gender and anxiety were analysed using a linear mixed-effect model with a P value <0.05.Results Solution deposition pain was significantly less (P <0.001) with the Dentapen infiltration than the traditional infiltration. The preference survey revealed that 75% of patients preferred the Dentapen infiltration over the traditional technique.Conclusions The findings of this clinical trial suggest that pain during maxillary lateral incisor infiltrations can be reduced by using the Dentapen with a slow flow rate and ramp-up mode compared with the traditional syringe technique.