Traditional Syringe Research Articles

Efficacy of sonic and ultrasonic activation on irrigant penetration in different tapered preparations: An in vitro study

ABSTRACT Background: The traditional syringe needle irrigation method would compromise on cleaning the intricacies of the complex root canal system. Current literature has focused on the benefits of various irrigant activation techniques. The present study aims to evaluate the irrigant penetration in extracted single-rooted teeth using various irrigant activation systems in different tapered preparations. Materials and Methods: One hundred and twenty-four single-rooted teeth were selected for the present study. They were standardized at the level of cementoenamel junction and shaped to 30 size using 4% and 6% taper rotary instruments under a standard irrigation regimen. Once the complete root canal preparations were done based on activation protocols, they were divided into four groups as Group 1: Four percent preparation sonic activation (n = 31), Group 2: Six percent preparation sonic activation (n = 31), Group 3: Four percent preparation ultrasonic activation (n = 31), and Group 4: Six percent preparation ultrasonic activation (n = 31). A radiopaque solution in conjunction with radiography was utilized to evaluate the penetration of irrigants into the canal. Radiographs were taken after dye injection to measure the length of irrigant penetration in each technique. Results were statistically analyzed using SPSS software. One-way ANOVA and Post hoc Tukey tests were performed. Results: The results of the study revealed that ultrasonic activation after 6% taper instrumentation was better followed by ultrasonic activation after 4% taper instrumentation (P < 0.05). The results revealed a statistically significant difference (P < 0.05) between the irrigation techniques. Conclusion: Ultrasonic irrigant activation proved to be a better and an effective technique for cleaning the root canal.

Efficacy of computer-controlled local anesthesia delivery system on pain in dental anesthesia: a systematic review of randomized clinical trials.

Computer-controlled local anesthesia delivery (CCLAD) is an innovative electronic injection device that represents a cutting-edge approach to dental anesthesia. This system is promising for painless anesthesia using controlled anesthetic injections. This review aimed to compare the discomfort experienced by patients during local anesthesia using a traditional syringe and the CCLAD system and evaluate the potential of the CCLAD system as a painless dental anesthesia solution. The inclusion criteria for this study were based on the recommendations of the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines. The study population, including children and adults, underwent dental anesthesia using the CCLAD system, ensuring a comprehensive and representative sample that instills confidence in the validity of the results. Fourteen clinical trials were included in the analysis after they fulfilled the eligibility criteria. We found that using computer-assisted anesthetic equipment not only led to a significantly lower pain perception score, but also had a profound positive impact on patient behavior. Patients using the CCLAD device exhibited more cooperative and helpful conduct, indicating the system's effectiveness in improving patient comfort and experience and reassuring the audience about its positive impact. In conclusion, using a computer-assisted anesthetic device such as the CCLAD system significantly reduced pain perception scores and improved patient behavior, making them more cooperative and helpful. These findings offer hope for pediatric dentistry and apprehensive adult patients, suggesting a more comfortable and less daunting dental experience with the CCLAD system.

Surgical Site Infiltration with Comfort-in Device and Traditional Syringe in Dogs Undergoing Regional Mastectomy: Evaluation of Intra- and Postoperative Pain and Oxidative Stress.

The surgical site infiltration of a local anesthetic is defined as the direct injection of a drug. This study aimed to compare the effects of surgical site infiltration with 4 mg kg-1 lidocaine using a Comfort-in device and traditional syringe on oxidative status and intra- and postoperative pain in dogs undergoing regional mastectomy. Sixty adult female dogs divided into C (Comfort-in device), S (traditional syringe), and CTR (control) groups received 2 µg kg-1 dexmedetomidine and 4 mg kg-1 tramadol IM, 5 mg kg-1 tiletamine/zolazepam IV, and isoflurane. The physiological and anesthesiological parameters were measured. The assessment of intra- and postoperative responses to the surgical stimulus was performed using a cumulative pain scale (CPS score of 0-4) and the Colorado Pain Scale (CSU-CAPS score of 0-4). The hematological and biochemical parameters and inflammatory oxidative status were measured. The CPS scores showed no significant differences between the C and S groups (p = 0.236), while the comparison between the CTR, C, and S groups, respectively, showed a significant difference (p < 0.001). The postoperative analgesia scores were significantly lower in the C group compared to those of the S and CTR groups (p < 0.001). In the C group, no subject received rescue analgesia during the intra- and postoperative periods. The level of oxidative inflammatory stress was lower in group C than those in S and CTR groups, and no side effects were observed in all the groups.

Evaluating Child Behavior and Preference Toward NumBee and Traditional Syringe (a Randomized Clinical Trial)

BACKGROUND: Local anesthetics are the gold standard for pain control in dentistry. Most patients still view the “needle” as a source of anxiety and disruptive behavior rather than relief. The patient’s cooperation and comfort level will increase with the administration of painless local anesthetic injection using appropriate technique. The purpose of this study was to assess the patient cooperation and behavior after receiving local anesthesia injection and to compare patients’ acceptance and preference of needleless NumBee anesthetic delivery device to conventional dental syringe. MATERIALS AND METHODS: 30 non-fearful 6-8-year-olds who had never been to the dentist were selected for the study using a split-mouth design. They underwent a simple class I restoration on both mandibular permanent first molar teeth in two separated dental visits. The Frankl behavior rating scale was used to assess patient behavior following injection. Patients expressed their preference and acceptance of the used syringes by answering a questionnaire. RESULTS: After injection by either method, 25 patients had Frankl behavior rating score of 4. Patients that had a negative response with the traditional method, showed a score of 2, following NumBee injection (p=0.035). CONCLUSION: Patients accepted both methods, and NumBee may induce less fear, with minimum stinging and unpleasant taste.

Effectiveness of a needle-free local anesthetic technique compared to the traditional syringe technique for the restoration of young permanent molars: a single-blind randomized clinical trial

Effectiveness of a needle-free local anesthetic technique compared to the traditional syringe technique for the restoration of young permanent molars: a single-blind randomized clinical trial

Closed System Transfer Devices (CSTDs): Understanding Potential Over- and Under- Dosing of Liquid Vial Drug Products and How to Generally Mitigate

Closed system transfer devices (CSTDs) are a major challenge for drug manufacturers to assess and assure drug compatibility and acceptable dosing accuracy for a range of clinical administration strategies. In this article, we systematically investigate parameters affecting the loss of product during transfer by CSTDs from vials to infusion bags. We show that liquid volume loss increases with vial size, vial neck diameter, and solution viscosity - while dependent on stopper design. We further compared CSTDs’ performance with a traditional syringe transfer and learned that loss is larger for CSTDs than for syringe transfer. Based on experimental data, a statistical model was developed to predict drug loss upon transfer by CSTDs. The model predicted that, for single dose vials with USP<1151> conforming overfill, a complete extraction and transfer of the full dose can be assured for a broad range of CSTDs, product viscosities, and vial types (2R, 6R, 10R, 20R) if a flush (of syringe, syringe adaptor, bag spike) is performed. The model also predicted that complete transfer cannot be achieved for fill volumes ≤ 2.0 mL. For multi-dose vials and pooling of several vials, respectively, the effective dose transfer (i.e., ≥ 95%) for all CSTDs tested was predicted to be achieved if a minimum of 5.0 mL is transferred.

Smear Layer and Debris Removal from Root Canals Comparing Traditional Syringe Irrigation and 3D Cleaning: An Ex Vivo Study.

Background: Endodontic treatment objectives comprise eliminating or decreasing bacterial load inside the complex endodontic space. Removing the smear layer and debris becomes mandatory to achieve good three-dimensional (3D) cleaning. Aim: This study assesses the difference in smear layer removal using the 3D cleaning technique and traditional syringe needle irrigation. The 3D cleaning technique includes the ultrasonic activation of intracanal-heated NaOCl. Materials and Methods: Our current study used single-rooted human mandibular premolar teeth to test the earlier-mentioned technique (n = 30). Initially, an endodontic access cavity was performed. Consequently, specimens were randomly distributed into three study groups according to irrigation protocol. The groups were Group 1, where the traditional syringe needle irrigation system was applied; Group 2, where the 3D cleaning technique was performed; and Group 3, in which teeth remained uncleaned as it was regarded as the control group. Once the experiment was completed, the teeth were decoronated at the cementoenamel junction (CEJ) and examined using scanning electron microscopy (SEM). Debris and smear layers were viewed in 1000× magnification and scored. Results: Statistical analysis was performed with a standard statistical software package (SPSS, version 28.0; SPSS IBM, Armonk, NY, USA). Data were analyzed with a nonparametric analysis of variance (Kruskal−Wallis ANOVA) among the groups tested and among the thirds of the canals. The level of significance was set at p < 0.05. A statistically significant (p < 0.05) lower mean smear layer and debris score was observed in both study groups compared to the control group. Group 2 showed better results compared to Group 1. Conclusions: The present study concluded that the 3D cleaning technique is an effective irrigation method for removing debris and smear layers. Future research, such as CLSM (Confocal Laser Scanning Microscopy) and Histological study, should be employed to confirm this study’s conclusion.

Micro-CT Evaluation of Different Root Canal Irrigation Protocols on the Removal of Accumulated Hard Tissue Debris: A Systematic Review and Meta-Analysis.

Accumulated hard tissue debris (AHTD) is an inevitable by-product during endodontic treatment and is difficult to remove completely using traditional syringe and needle irrigation (SNI). Adjunctive irrigation is proposed to assist the clean-up of AHTD. This systematic review and meta-analysis aimed to evaluate the AHTD removal efficacy of different root canal irrigation devices using micro-computed tomography (Micro-CT). A literature search was carried out within the main scientific databases until 20 June 2022. All results were screened with detailed eligibility criteria. Eleven studies were included for analysis. SNI, passive ultrasonic irrigation (PUI), negative pressure systems, sonically activated irrigation (SAI), mechanical-activated system and laser-activated irrigation (LAI) were assessed. PUI is superior to SNI for debris removal and LAI has better AHTD removal performance than PUI. The negative pressure system and mechanical-activated system were proved to be less effective. Registration: PROSPERO (CRD42021273892).

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

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.

The eye wash technique: A simple and effective technique for intraoperative ocular surface lavage

Objectives: The author proposes an extremely effective and practical method of ocular surface hydrating and cleaning during anterior segment surgery, the Eye Wash Technique (EWT), in substitution for the traditional methods employing a syringe and cannula for ocular irrigation. Materials and Methods: The EWT utilizes the intraocular irrigating solution (IS) used in the surgery. It is performed by employing the irrigating line of the phacoemulsification (phaco) machine or the irrigating fluid IV drip in case of manual cataract surgery. The eye irrigation is performed directly from the Luer end attachment of these irrigating lines, which is positioned above the inner cantus pointing to the globe’s nasal limbal region. With the phaco machine pedal in position 1 (irrigation only) or in panel continuous irrigation mode in case of phaco surgery, or by opening the roller clamp of the IV drip line in case of manual surgery, IS flow ensues and is directed to the eye from a nasal direction to provide a steady flow to wash the exposed eye surface as well as the lid margins and lid speculum. The irrigation is maintained for two to five seconds with side-to-side jiggling if needed, to ensure complete ocular surface coverage. Cornea hydration is achieved and any unwanted material on the ocular surface is washed out. Results: The EWT was easily incorporated into the surgical routine with no difficulty in adaptation to the technique or in its employment. The surgical time was not prolonged when employing the technique. The EWT effectively provided both corneal hydration and ocular surface cleaning every time it was used, with no need to resort to the traditional syringe and cannula irrigation method at any time. Conclusion: The EWT should be incorporated into the anterior segment surgical routine and performed at the beginning of surgery, before inserting the intraocular lens, and at the end of the surgery; also, at any time during surgery should the need arise, enhancing anterior segment surgical visualization and safety.

Pain perception in paediatric patients: evaluation of computerised anaesthesia delivery system vs conventional infiltration anaesthesia in paediatric patients.

The aim of the present study is to compare the effectiveness of a computerised system (QuickSleeper) compared to traditional syringe in injection of local anaesthetic focusing on the perception of anxiety and pain in paediatric patients. Study design: 100 children aged between 3 and 15 years in need of two dental treatments that required local anaesthesia were selected and treated randomly but alternately with computerised and traditional local anaesthesia. After each anaesthetic injection, patient's anxiety was measured using the Venham test. Electronic anaesthesia showed statistically significant better results than traditional anaesthesia according to the Venham pain scale, in both mandibular and maxillary sites. Statistics: Data were analysed using the paired Wilcoxon test. The computer-assisted anaesthesia system resulted in a significantly lower pain perception score and yielded to helpful, cooperative behaviour. For this reason, it is an advantageous alternative to traditional injection anaesthesia and can avoid invasive treatments and trauma for young patients.

Standardization of Antigen-Emulsion Preparations for the Induction of Autoimmune Disease Models.

Autoimmune murine disease models are vital tools for identifying novel targets and finding better treatments for human diseases. Complete Freund’s adjuvant is commonly used to induce disease in autoimmune models, and the quality of the adjuvant/autoantigen emulsion is of critical importance in determining reproducibility. We have established an emulsification method using a standard homogenizer and specially designed receptacle. Emulsions are easy to prepare, form stable and uniform water-in-oil particles, are faster to make than the traditional syringe method, use less material and are designed to fill syringes with ease. In the present study, we have validated the emulsions for induction of experimental autoimmune encephalitis, collagen II induced arthritis, antigen induced arthritis, and delayed type hypersensitivity models. These models were induced consistently and reproducibly and, in some cases, the new method outperformed the traditional method. The method described herein is simple, cost-effective and will reduce variability, thereby requiring fewer animals for in vivo research involving animal models of autoimmune disease and in vaccine development.

Comparison of Maxillary Lateral Incisor Infiltration Pain Using the Dentapen and a Traditional Syringe: A Prospective Randomized Study

IntroductionThe anterior maxillary infiltration is one of the more painful dental injections. The Dentapen is an electronic syringe that uses computer-controlled delivery technology to administer dental local anesthesia at a slow controlled rate. The purpose of this prospective, randomized, single-blind study was to evaluate solution deposition pain of a maxillary lateral incisor infiltration using the Dentapen with the slow flow rate (1.8 mL/162 sec) and ramp-up setting compared with a traditional syringe infiltration at a flow rate of 1.8 mL/60 sec. MethodsOne hundred thirty adults were administered a maxillary lateral incisor infiltration with the Dentapen and a traditional syringe at 2 separate appointments in a single-blind manner. The infiltrations of 2% lidocaine with 1:100,000 epinephrine were given at a rate of 1.8 mL/162 sec with the ramp-up feature for the Dentapen and 1.8 mL/60 sec for the traditional infiltration. The pain of solution deposition was recorded on a visual analogue scale. At the conclusion of the study, subjects selected their preferred injection technique. The data were analyzed statistically using paired t tests, a mixed-effect model, and odds ratio. ResultsThe pain of solution deposition was significantly less for the Dentapen injection than the traditional injection (P < .001). With the Dentapen device, 16% experienced moderate pain, and for the traditional syringe, 39% experienced moderate pain. Overall, 75% of subjects preferred the Dentapen injection over the traditional injection. ConclusionsThe Dentapen, using the slow flow rate and ramp-up mode, significantly reduced the pain of solution deposition for maxillary lateral incisor infiltrations.

Bioelectronic Implants and Their Role in Modern Medicine

Humanity turned to medicines millions of years ago, when medicinal plants were used for healing. In the century before last, a significant contribution to medicine was made by various fields of science; in particular, here one can name a device that has long been used to deliver medicine to the body – a syringe.&#x0D; Today, the use of injections of drugs of biological origin is a common practice for the treatment of chronic diseases, but the injection procedure itself is often associated with painful perceptions, and the field of injection is limited. Modern advanced therapies are genetic, electronic and cellular therapies that can meet the needs of caregivers, as well as the patients themselves.&#x0D; It is well known that digital processes in healthcare are currently undergoing intensive development, and in this context, innovative bioelectronic devices are being used to implement new strategies for personalized injection therapy. This paper examines aspects of the development of innovative methods of drug delivery to the patient's body, such as optogenetic therapy, optogenetic methods, and genetic therapy. For these purposes, bioelectronic implants are used today, in which electronics and optogenetics interact with the help of light, transmitting a certain induction signal to each other. By controlling the synthetic optogenetic pathway in the cell, drugs can be delivered to a particular organ within a clearly limited space or time.&#x0D; Present technology is revolutionary in medicine, as it can replace a traditional syringe, increasing the accuracy of dosage and time of drug administration, while reducing the involvement of the human factor to a minimum. The technology under consideration also acts as minimally invasive, which minimizes the patient's discomfort when taking medications.

Kitosan ve EDTA Solüsyonlarının Sonik ve Ultrasonik Sistemler ile Aktive Edilmesinin Dentin Mikrosertliğine Olan Etkisi

Objective: The aim of this in vitro study is to assess the effect of activation of EDTA and chitosan by different irrigation activation systems on the microhardness of root canal dentin. Material and Methods: A total of 60 single-rooted extracted mandibular premolars were prepared and randomly distributed into two groups (n=30) based on the final irrigant: Group 1, 0.2% chitosan; Group 2, 17% EDTA. Then, specimens of both groups were randomly divided into three subgroups (n=10) based on the irrigant activation; Subgroup A (Sonic), Subgroup B (Ultrasonic) and Subgroup C (Conventional irrigation, control group). The specimens (n=60) were embedded into resin blocks and sectioned horizontally 1 mm thick sections from 2,5 and 8 mm levels from the apex. All samples were used to determine the microhardness of dentin using a Vicker's microhardness tester. The data were analyzed using the three-way analysis of variance (ANOVA) and Tukey post-hoc tests to detect the effects of the independent variables (final irrigation solution, final irrigation techniques, and root canal thirds) on microhardness. Results: The three-way ANOVA indicated that chitosan exhibited a significantly lower microhardness value than EDTA (p<0.001). Also, regardless of the usage of final irrigation, both PUI and EA had significantly lower microhardness than CI (p<0.001). Conclusion: Chitosan as compared to EDTA (i), sonic (EA) and ultrasonic (PUI) final irrigation activation methods as compared to the traditional syringe method (CIS) (ii), apical and mid regions of the root as compared to its coronal region (iii), showed lower microhardness values.

Evaluation of a vial adaptor to ensure safe and efficient needle-free transfer of cells post-cryopreservation in preparation for drug delivery

Background & Aim The commercialization of cells for therapeutic use drives a critical need for the refinement of cell storage and handling procedures, ensuring the integrity of cell-based products is maintained throughout the product life cycle. One area for refinement is the transfer of cells from a sealed container system after they have been cryopreserved, stored, shipped and thawed. There are many parameters that may affect either the total volume or the viability of the cells recovered. These include the type of transfer equipment used, the properties of the cryo-formulations that may have different viscosities or rheology, and the proficiency of the manual operator performing the task. This study investigates the comparability of a vial adaptor when compared to a traditional needle and syringe for recovering cells from a sealed cyclic olefin polymer (COP) vials after cryopreservation and storage for one week at -180°C. Methods, Results & Conclusion One experiment was designed to evaluate the effect of operator variability (n = 4) when transferring 1 ml fill volumes containing 1 × 106 cells/ml stored in Cryostor CS10 using a vial adaptor or needle and syringe. Bone marrow-derived human mesenchymal stem cells (hMSCs) and cord blood hematopoietic stem cells (HSCs) were used as exemplar adherent and suspension cell types. Total volume recovery from each system was measured, as was morphology, cell yield and viability after a 4-day outgrowth to determine cell and volume losses from the transfer process. A second experiment looked at the effect different cell densities and cryo-formulations may have during transfer. 1ml vials of hMSCs at different densities (5 e5/ml and 4 e6/ml) were prepared and stored in 4 different formulations with differing colloidal components. The cell yield and viability were measured immediately post-transfer as was total recovered volume. The results showed that recovery of both intact cells and product volume were >80% for recovered volume with a suitable cryo-formulation regardless of transfer method (Figure 1). The vial adaptor was comparable in performance to a needle and syringe, thus providing a safe needle-free alternative for operators during manual transfer. Furthermore, the data highlighted the how cryo-formulation choice and operator variability can impact upon overall product recovery in a cell therapy context.

Temperature Gradients Drive Bulk Flow Within Microchannel Lined by Fluid-Fluid Interfaces.

Surface tension gradients induce Marangoni flow, which may be exploited for fluid transport. At the micrometer scale, these surface-driven flows can be quite significant. By introducing fluid-fluid interfaces along the walls of microfluidic channels, bulk fluid flows driven by temperature gradients are observed. The temperature dependence of the fluid-fluid interfacial tension appears responsible for these flows. In this report, the design concept for a biocompatible microchannel capable of being powered by solar irradiation is provided. Using microscale particle image velocimetry, a bulk flow generated by apparent surface tension gradients along the walls is observed. The direction of flow relative to the imposed temperature gradient agrees with the expected surface tension gradient. The phenomenon's ability to replace bulky peripherals, like traditional syringe pumps, on a diagnostic microfluidic device that captures and detects leukocyte subpopulations within blood is demonstrated. Such microfluidic devices may be implemented for clinical assays at the point of care without the use of electricity.

Microneedles combined with a sticky and heatable hydrogel for local painless anesthesia.

In view of the inherent defects of traditional syringe anesthesia (pain, inaccurate anesthesia area, swelling after injection, slow recovery etc.), this article proposed a new anesthesia system based on microneedles and a hydrogel. After loading with AuNPs, a sticky PDA-PAM-AuNP hydrogel with near-infrared (NIR) light response properties was prepared here. After using microneedles (to open the skin of the target anesthesia area), a hydrogel patch embedded with a medical anesthetic soaked sponge was pasted to realize local painless anesthesia. The effects of anesthesia can also be modulated by external NIR. Compared to traditional syringe anesthesia, this hydrogel + microneedle method resulted in reduced pain, higher anesthetic accuracy and faster recovery, making it a promising local anesthesia alternative in clinical applications.

Personal Technique of Microinfiltration With Botulin Toxin: The SINB Technique (Superficial Injection Needling Botulinum).

The superficial injection needling botulinum (SINB) technique is the dermal injection of microdoses of botulin toxin, not by traditional syringe but with needling technique that consists in multiple microdroplets by electrical device. The intention is to decrease sweat and sebaceous gland activity to improve skin texture and sheen and to target the superficial layer of muscles that find attachment to the undersurface of the dermis causing visible rhytides. The technique is for treatment of face and neck by the injection of the botulin toxin into the dermis or in subdermal plane to improve skin texture, smoothen horizontal creases, and decrease vertical banding of the neck as well as to achieve better apposition of the platysma to the jawline and neck, improving contouring of the cervicomental angle. The botox solution is hyperconcentrated when compared to traditional dilution or compared to microbotox or mesobotox. Furthermore, the injection technique is different because spreading superficial microdroplets are not performed, but small, homogeneous, and controlled amounts of solution are injected. Each 0.8-mL syringe contains 50 units of onabotulinumtoxinA. The solution is delivered intradermally, using an electrical needling pen and setting the depth penetration of the needles at 3 to 3.5 mm. The 2 conjugated techniques play a 2-fold action on the skin. The technique was applied to a group of 63 patients dealing with face, forehead, cheekbones, and neck.

Dental anaesthesia for children – effects of a computer-controlled delivery system on pain and heart rate: a randomised clinical trial

Local anaesthesia in dentistry is usually given by conventional injection through a syringe. In this randomised, single-blind, split-mouth clinical study we evaluated the perception of pain and changes in heart rate in children being given dental local anaesthesia using a computer-controlled device compared with that given using a traditional syringe. Participants were in good general health with no contraindications to local anaesthetics. One half of each maxilla was anaesthetised using each technique, the order having been randomly selected according to a computer-generated sequence. The hypothesis was that the controlled anaesthetic flow rate results in virtually imperceptible injections. The outcomes were the perception of pain and the heart rate. Seventy-six children aged from 5–12 years old participated in this study. The mean (SD) pain score of the conventional injection was 5.51 (2.46) and the mean (SD) heart rate was 2.72 (6.76), which were significantly higher than those of the computerised delivery system, which were 4.74 (2.8) and 0.34 (7.3) (p=0.04). More patients anaesthetised with the traditional syringe technique required a second injection (n=21). These results suggest that dental anaesthesia given to children with a computer-controlled delivery system reduced pain better than that given with a conventional syringe.