Syringe micro vibrator (SMV) a new device being introduced in dentistry to alleviate pain and anxiety of intraoral injections, and a comparative study with a similar device

Amir Hashem Shahidi Bonjar, Amir Hashem Shahidi Bonjar

Abstract

Background: Neurologically, it is proven that stimulation of larger diameter fibers - e.g. using appropriate coldness, warmth, rubbing, pressure or vibration- can close the neural "gate" so that the central perception of itch and pain is reduced. This fact is based upon "Gate-control" theory of Melzack and Wall.

Presentation of the hypothesis: Syringe Micro Vibrator is a new design being introduced for the first time in the field of Dentistry. This device is a promising breakthrough in pain and anxiety management and may deliver solution for clinicians plagued with patient pain phobia. It has an off-set rotating micro vibration creator with ultra high frequency and ultra low altitude that can be easily placed on any standard dental syringe and some disposable syringes. This device was registered as an invention in dentistry and received Iran National Patent number of 63765.

Testing the hypothesis: By creating micro vibration, this device would be effective in reducing the pain and anxiety confronted with most types of intraoral injections as palatal, mandibular block, intraligamental and local infiltration. From the aspect of the patient pain management, this device contributes both physiologically (based on Gate Control Theory of pain) and psychologically (based on the device function as will be explained by dentist to the patient as a modern pain reducing technology). From the aspect of clinician, SMV motor provides vibrations with ultra high frequency to alleviate pain, but since it has ultra low vibration altitude, it has no adverse effect on the clinician dexterity and accuracy during injection and it does not interfere with pin point localization of injection site.

Implications of the hypothesis: Upon mounting on a conventional dental anesthesia injection syringe, SMV is switched on and the clinician then uses normal injection technique to administer the anesthetic. This device is not only a useful accessory device for ordinary patients, but also more useful for pediatric patients and those who have a phobia of intraoral injection or pain.

Figures

Figure 1
Figure 1
Structural components of Syringe Micro Vibrator (SMV) and its mounting position on dental syringe barrel. A) Posterior-anterior view of SMV, structural components consist of: a) stainless steel shell containing motor and eccentrically weighted plate, b) power switch, c) stainless steel cap, d) four flexible attachment arms for firm attachment and e) shell concavity for well adaptation on syringe barrel. B) Anterior-posterior view of SMV and stainless steel cap bearing button cell batteries, C) SMV is applicable to most standard conventional syringes which compensates minute variations of different barrel diameters through four flexible grasping positioning arms and shell concavity, D) SMV mounted on syringe barrel and E) Lateral syringe view indicates that mounting of SMV causes no restriction for the replacement of cartridge.

References

    1. IASP Task Force on Taxonomy. Part III: Pain Terms, a Current List with Definitions and Notes on Usage. In: Merskey H, Bogduk N, editor. Classification of Chronic Pain. 2. WA, Seattle; IASP Press; 1994. pp. 209–214.
    1. Hardy PAJ. Chronic pain management: the essentials. UK; Greenwich Medical Media; 1997. pp. 13–21.
    1. Milgrom P, Codwell SE, Getz T, Weinstein P, Ramsay DS. Four dimentions of fear of dental injections. J Am Dent Assoc. 1997;128:756–66.
    1. Fiset L, Milgrom P, Weinstein P, Getz T, Glassman P. Psycophysiological responses to dental injections. J Am Dent Assoc. 1985;111:578–583.
    1. Berggren U. General and specific fears in referred and self-referred adult patients with extreme dental anxiety. Behav Res Ther. 1992;40:395–401. doi: 10.1016/0005-7967(92)90051-H.
    1. O'Brien L, Taddio A, Lyszkiewicz DA, Koren G. A critical review of the topical local anesthetic amethocaine (Ametop) for pediatric pain. Paediatr Drugs. 2005;7:41–54.
    1. Pollack S. Pain control by suggestion. J Oral Med. 1966;21:89–95.
    1. Touyz LZ, Lamontagne P, Smith BE. Pain and anxiety reduction using a manual stimulation distraction device when administering local analgesia oro-dental injections: a multi-center clinical investigation. J Clin Dent. 2004;15:88–92.
    1. Aminabadi NA, Farahani RM, Balayi Gajan E. The efficacy of distraction and counter stimulation in the reduction of pain reaction in intraoral injection by pediatric patients. The J Contemp Dent Pract. 2009;9:33–40.
    1. Ong EL, Lim NL, Koay CK. Towards a pain free venopuncture. Anaesthesia. 2000;55:260–262. doi: 10.1046/j.1365-2044.2000.01124.x.
    1. Scarfone RJ, Jasani M, Gracely EJ. Pain of local anesthetics: rate of administration and buffering. Ann Emerg Med. 1998;31:36–40. doi: 10.1016/S0196-0644(98)70278-1.
    1. Colaric KB, Overton DT, Moore K. Pain reduction in lidocaine administration through buffering and warming. Am J Emerg Med. 1998;16:353–365. doi: 10.1016/S0735-6757(98)90126-7.
    1. Masters JE. Randomized control trial of pH buffered lignocaine with adrenaline in outpatient operations. Br J Plast Surg. 1998;51:385–387.
    1. Orlinsky M, Hudson C, Chan L, Deslauriers R. Pain comparison of unbuffered versus buffered lidocaine in local wound infiltration. J Emerg Med. 1992;10:411–415. doi: 10.1016/0736-4679(92)90269-Y.
    1. Younis I, Bhutiani RP. Taking the 'ouch' out- effect of buffering commertial xylocaine on infiltration and procedure pain - a positive, randomized, double-blind, controlled trial. Ann R Coll Surg Engl. 2004. pp. 213–7.
    1. Bartfield JM, Crisaffulia KM, Raccio-Robak N, Salluzzo RF. The effects of warming and buffering on pain of infiltration of lidocaine. Acad Emerg Med. 1995;2:254–8. doi: 10.1111/j.1553-2712.1995.tb03218.x.
    1. Fitton AR, Ragbir M, Milling MA. The use of pH adjusted lingnocaine in controlling operative pain in the day surgery unit: a positive randomized trial. Br J Plast Surg. 1996;49:404–8. doi: 10.1016/S0007-1226(96)90011-9.
    1. Kakigi R, Shibasaki H. Mechanisms of pain relief by vibration and movement. J Neurol Neurosurg Psychiatry. 1992;55:282–286. doi: 10.1136/jnnp.55.4.282.
    1. Lundeberg T, Nordemar R, Ottoson D. Pain alleviation by vibration stimulation. Pain. 1984. pp. 25–44.
    1. Nanitsos E, Vartuli R, Forte A, Dennison PJ, Peck CC. The effect of vibration on pain during local anaesthesia injections. Aust Dent J. 2010;54:94–100. doi: 10.1111/j.1834-7819.2009.01100.x.
    1. Roy EA, Hollins M, Maixner W. Reduction of TMD pain by high-frequency vibration: a spatial and temporal analysis. Pain. 2003;101:267–74. doi: 10.1016/S0304-3959(02)00332-9.
    1. Weerakkoby NS, Percival P, Hickey MW, Morgan DL, Gregory JE, Canny BJ, Porske U. Effects of local pressure and vibration on muscle pain from eccentric exercise and hypertonic saline. Pain. 2003;105:425–435. doi: 10.1016/S0304-3959(03)00257-4.
    1. Yarnitsky D, Kunin M, Brik R, Specher E. Vibration reduces thermal pain adjacent dermatomes. Pain. 1997;69:75–7. doi: 10.1016/S0304-3959(96)03250-2.
    1. Melzack R, Schecter B. Itch and vibration. Science. 1965;26:1047–8. doi: 10.1126/science.147.3661.1047.
    1. Dahlin L, Lund I, Lundberg T, Molander C. Vibratory stimulation increases the electro-cutaneous sensory detection and pain thresholds in women but not in men. BMC Complement Altern Med. 2006;6:20. doi: 10.1186/1472-6882-6-20.
    1. Ottoson D, Ekblom A, Hasson P. Vibratory stimulation for the relief of pain of dental origin. Pain. 1981;10:37–45. doi: 10.1016/0304-3959(81)90043-9.
    1. Lundeberg T, Abrahamsson P, Bondesson L, Haker E. Effect of vibratory stimulation on experimental and clinical pain. Scand J Rehabil Med. 1988;20:149–169.
    1. Hagbarth KE, Eklund G. Motor effects of muscle vibration in spasticity, rigidity and cerebellar disorders. J Neurol Neurosurg Psychiatry. 1968;31:207–213. doi: 10.1136/jnnp.31.3.207.
    1. Melzack R, Wall P. Pain mechanisms: a new theory. Science. 1965;150:971–979. doi: 10.1126/science.150.3699.971.
    1. Sufka KJ, Price DD. Gate Control Theory reconsidered. Brain Mind. 2002;2:277–90. doi: 10.1023/A:1019996809849.
    1. Wright GZ. In: Dentistry for the child and adolescent. 8. McDonald RE, Avery DR, Dean JA, editor. St Louis: Mosby; 1994. Nonpharmacologic management of children's behaviors; pp. 38–39.
    1. Zoppi M, Voegelin MR, Signorini M, Zamponi A. Pain threshold changes by skin vibratory stimulation in healthy subjects. Acta Physiol Scand. 1991;143:439–443. doi: 10.1111/j.1748-1716.1991.tb09256.x.
    1. Blair J. Vibraject from ITL Dental. Dent Econ. 2002;92:90.
    1. Yoshikawa F, Ushito D, Ohe D, Shirasishi Y, Fukayama H, Umino M. Vibrating dental local anesthesia attachment to reduce injection pain. J Jpn Dent Soc Anesthesiol. 2003;31:194–195.
    1. Saijo M, Ito E, Ichinohe T, Kaneko Y. Lack of Pain Reduction by a Vibrating Local Anesthetic Attachment: A Pilot Study. Anesthesiol Prog. 2005;52:62–64. doi: 10.2344/0003-3006(2005)52[62:LOPRBA];2.
    1. DentistryIQ. Minimizing injection pain and stress.
    1. Litt MD. A model of pain and anxiety associated with acute stressors: Distress in dental procedures. Behav Res Ther. 1996;34:459–76. doi: 10.1016/0005-7967(96)00015-0.

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