Comparison of acceptance, preference and efficacy between pressure anesthesia and classical needle infiltration anesthesia for dental restorative procedures in adult patients

Chetana Sachin Makade, Pratima R Shenoi, Mohit K Gunwal, Chetana Sachin Makade, Pratima R Shenoi, Mohit K Gunwal

Abstract

Introduction: Intraoral local anesthesia is essential for delivering dental care. Needless devices have been developed to provide anesthesia without injections. Little controlled research is available on its use in dental restorative procedures in adult patients. The aims of this study were to compare adult patients acceptability and preference for needleless jet injection with classical local infiltration as well as to evaluate the efficacy of the needleless anesthesia.

Materials and methods: Twenty non fearful adults with no previous experience of dental anesthesia were studied using split-mouth design. The first procedure was performed with classical needle infiltration anesthesia. The same amount of anesthetic solution was administered using MADA jet needleless device in a second session one week later, during which a second dental restorative procedure was performed. Patients acceptance was assessed using Universal pain assessment tool while effectiveness was recorded using soft tissue anesthesia and pulpal anesthesia. Patients reported their preference for the anesthetic method at the third visit. The data was evaluated using chi square test and student's t-test.

Results: Pressure anesthesia was more accepted and preferred by 70% of the patients than traditional needle anesthesia (20%). Both needle and pressure anesthesia was equally effective for carrying out the dental procedures.

Conclusion: Patients experienced significantly less pain and fear (p<0.01) during anesthetic procedure with pressure anesthesia. However, for more invasive procedures needle anesthesia will be more effective.

Keywords: Injection pain; jet injection; local anesthesia; needleless anesthesia; oral anesthesia; pressure anesthesia.

Conflict of interest statement

Conflict of Interest: None declared.

References

    1. Corah NL, O’Shea RM, Ayer WA. Dentists’ management of patients’ fear and anxiety. J Am Dent Assoc. 1985;110:734–6.
    1. Munshi AK, Hegde A, Bashir N. Clinical evaluation of the efficacy of anesthesia and patient preference using the needle-less jet syringe in pediatric dental practice. J Clin Pediatr Dent. 2001;25:131–6.
    1. Milgrom P. Increasing dental patients’ access to measures for anxiety, fear, and phobia management. Perspectives from a dental school-based fear clinic. Anesth Prog. 1986;33:62–4.
    1. Milgrom P, Coldwell SE, Getz T, Weinstein P, Ramsay DS. Four dimensions of fear of dental injections. J Am Dent Assoc. 1997;128:756–66.
    1. Milgrom P, Fiset L, Melnick S, Weinstein P. The prevalence and practice management consequences of dental fear in a major US city. J Am Dent Assoc. 1988;116:641–7.
    1. Gatchel RJ, Ingersoll BD, Bowman L, Robertson MC, Walker C. The prevalence of dental fear and avoidance: A recent survey study. J Am Dent Assoc. 1983;107:609–10.
    1. Dabarakis NN, Alexander V, Tsirlis AT, Parissis NA, Nikolaos M. Needle-less local anesthesia: Clinical evaluation of the effectiveness of the jet anesthesia injex in local anesthesia in dentistry. Quintessence Int. 2007;38:E572–6.
    1. Bennett CR, Mundell RD, Monheim LM. Studies on tissue penetration characteristics produced by jet injection. J Am Dent Assoc. 1971;83:625–9.
    1. Saravia ME, Bush JP. The needleless syringe: Efficacy of anesthesia and patient preference in child dental patients. J Clin Pediatr Dent. 1991;15:109–12.
    1. Margetis PM, Quarantillo EP, Lindberg RB. Jet injection local anesthesia in dentistry: A report of 66 cases. U S Armed Forces Med J. 1958;9:625–34.
    1. Bennett CR, Monheim LM. Production of local anesthesia by jet injection. A clinical study. Oral Surg Oral Med Oral Pathol. 1971;32:526–30.
    1. Greenfield W, Karpinski JF. Needleless jet injection in comprehensive pain control and applications to oral surgery. Anesth Prog. 1972;19:94–7.
    1. Needle free injectors MADA jet XL. [Last accessed on 2011 Nov 26]. Available from: .
    1. Arapostathis KN, Dabarakis NN, Coolidge T, Tsirlis A, Kotsanos N. Comparison of acceptance, preference, and efficacy between jet injection INJEX and local infiltration anesthesia in 6 to 11 year old dental patients. Anesth Prog. 2010;57:3–12.
    1. Kaufman E, Epstein JB, Naveh E, Gorsky M, Gross A, Cohen G. A survey of pain, pressure, and discomfort induced by commonly used oral local anesthesia injections. Anesth Prog. 2005;52:122–7.
    1. Universal pain assessment tool. [Last accessed on 2011 Aug 7]. Available from: .
    1. Malamed SF. Handbook of Local Anesthesia. 5th ed. St. Louis, MO: CV Mosby; 2004. Basic injection technique; pp. 159–69.
    1. Hujoel PP, DeRouen TA. Validity issues in split-mouth trials. J Clin Periodontol. 1992;19:625–7.
    1. Antczak-Bouckoms AA, Tulloch JF, Berkey CS. Split-mouth and cross-over designs in dental research. J Clin Periodontol. 1990;17:446–53.
    1. Novaes TF, Matos R, Raggio DP, Braga MM, Mendes FM. Children's discomfort in assessments using different methods for approximal caries detection. Braz Oral Res. 2012;26:93–9.
    1. Wong DL, Baker CM. Pain in children: Comparison of assessment scales. Pediatr Nurs. 1988;14:9–17.
    1. Rajasagaram U, Taylor DM, Braitberg G, Pearsell JP, Capp BA. Paediatric pain assessment: Differences between triage nurse, child and parent. J Paediatr Child Health. 2009;45:199–203.
    1. Ogle OE, Mahjoubi G. Advances in local anesthesia in dentistry. Dent Clin North Am. 2011;55:481–99.
    1. Jena A, Shashirekha G. Effect of preoperative medications on the efficacy of inferior alveolar nerve block in patients with irreversible pulpitis: A placebo-controlled clinical study. J Conserv Dent. 2013;16:171–4.
    1. Ramachandran A, Khan SI, Mohanavelu D, Senthil Kumar K. The efficacy of pre-operative oral medication of paracetamol, ibuprofen, and aceclofenac on the success of maxillary infiltration anesthesia in patients with irreversible pulpitis: A double-blind, randomized controlled clinical trial. J Conserv Dent. 2012;15:310–4.
    1. Verma PK, Srivastava R, Ramesh KM. Anesthetic efficacy of X-tip intraosseous injection using 2% lidocaine with 1:80,000 epinephrine in patients with irreversible pulpitis after inferior alveolar nerve block: A clinical study. J Conserv Dent. 2013;16:162–6.

Source: PubMed

3
Abonneren