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      Comparative Assessment of Perceived Pain in Children During Palatal Anesthesia Using Two Injection Techniques: An In Vivo Study

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          Abstract

          Background:

          Computer-controlled local anesthetic delivery (CCLAD) is an approach that uses a constant and slow flow of delivering the anesthetic solution into the tissues, which is capable of alleviating pain and discomfort in children.

          Aim:

          Assessment of perceived pain in children during palatal anesthesia using Wand technique and conventional technique.

          Materials and Methods:

          A total of 30 children requiring bilateral palatal anesthesia were included in the study in a split-half design. The children were asked to indicate their intensity of pain response on a visual analog scale (VAS) after administration of anesthesia by the Wand technique and the conventional technique.

          Statistical Analysis:

          The data were analyzed using Statistical Package for the Social Sciences (SPSS) 16.0. Mann–Whitney U test compared the mean VAS scores between the two groups. Statistical significance was defined as a P value of less than 0.05.

          Results:

          The mean VAS scores using the Wand technique and the conventional technique were 3.87 ± 1.99 and 4.20 ± 1.44, respectively ( P = 0.332). Females had lesser VAS scores compared to males ( P = 0.008).

          Conclusion:

          Females readily accepted the Wand technique compared to males, although there was no substantial difference between the two injection procedures.

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          Most cited references23

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          Pain behaviour and distress in children during two sequential dental visits: comparing a computerised anaesthesia delivery system and a traditional syringe.

          To compare the pain and distress response of children receiving a local anesthesia injection using a computerised device (Wand) or a traditional syringe over two consecutive treatment sessions and to study whether the response to the two injection techniques was different for high or low dentally anxious children. Randomised controlled trial. Secondary dental care practice specialised in treating children. Children were selected and randomly allocated to the Wand or traditional injection condition. Parents completed the Dental Subscale of the Children's Fear Survey Schedule (CFSS-ds). Based on video recordings of the injections, for each 15 seconds, the occurrence of five pain related behaviours was registered and a score was given on the Venham distress scale. Children rated their pain after each injection. Over two consecutive treatment sessions one group received two local anaesthesia injections with the traditional syringe and the other group received two injections with the Wand. The mean number of pain related behaviours, the mean distress scores and the self-reported pain scores were compared. Based on the CFSS-ds subjects were split into highly and low dentally anxious children. One hundred and forty-seven subjects participated in the study: aged 4-11 years, 71 girls. Based on the behaviour displayed during the local anaesthesia injection and the self-reported pain after the injection, no difference could be found between an injection with the traditional syringe or the Wand over the first or second treatment session. However, on the first treatment session, highly anxious children reported more pain (p = 0.001), displayed more pain related behaviour (p = 0.002) and more distress (p <0.001) than low anxious children in reaction to the local anaesthesia injection. No clear difference in the response of referred children could be found between an injection with the Wand or the traditional syringe. Level of dental anxiety was found to be an important factor in the response of children to a local anaesthesia injection.
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            Comparison of a computerized anesthesia device with a traditional syringe in preschool children.

            The purpose of this investigation was to evaluate the efficacy of a computerized injection device (Wand) on reducing pain behavior during injections with preschool-aged children. Subjects consisted of 40 patients between the ages of 2 and 5 requiring local anesthesia for dental restorations in the maxilla. Patients were randomly assigned to either the Wand or the traditional anesthetic delivery system. A palatal approach to the anterior and middle superior alveolar nerves and the anterior superior alveolar nerve was used with the Wand injections. Buccal infiltration and palatal injections were used for the traditional method. Pain behavior was observed and coded. Results of Fisher Exact tests found that using the Wand to deliver anesthetic lead to significantly fewer (P < .01) disruptive behaviors in preschool-aged children when compared with a traditional injection regimen. In addition, none of the preschool-aged children exposed to the Wand required restraint during the initial interval, while nearly half of the children receiving a traditional injection required some type of immediate restraint. These results demonstrate that the Wand can significantly reduce disruptive behaviors in a population of young children who are traditionally more difficult to manage and may be one method of creating a more positive experience for the young child and the practitioner.
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              Effect of the DentalVibe injection system on pain during local anesthesia injections in adolescent patients.

              The purpose of this study was to compare the pain rating scale measurements from an exposure group (injections with the aid of DentalVibe Injection Comfort System) and control group (traditional injection without the aid of the DentalVibe) in adolescent patients using self-reported pain during administration of local anesthetic injections.
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                Author and article information

                Journal
                J Pharm Bioallied Sci
                J Pharm Bioallied Sci
                JPBS
                Journal of Pharmacy & Bioallied Sciences
                Wolters Kluwer - Medknow (India )
                0976-4879
                0975-7406
                July 2022
                13 July 2022
                : 14
                : Suppl 1
                : S503-S506
                Affiliations
                [1 ]Department of Pediatric and Preventive Dentistry, Nanded Rural Dental College and Research Centre, Nanded, Maharashtra, India
                [2 ]Department of Pediatric and Preventive Dentistry, Vananchal Dental College and Hospital, Gharhwa, Jharkhand, India
                [3 ]Department of Orthodontics, Himachal Pradesh, Simla, India
                [4 ]Department of Pediatric and Preventive Dentistry, Kings Dental Centre, Qatar, India
                [5 ]Department of Oral Pathology, Microbiology and Forensic Odontology, BIDSH, Patna, India
                [6 ]Specialty Registrar, Morriston Hospital, Swansea, United Kingdom
                Author notes
                Address for correspondence: Dr. Anand N. Patil, Department of Pediatric and Preventive Dentistry, Nanded Rural Dental College and Research Centre, Nanded, Maharashtra, India. E-mail: suggusuggu53@ 123456gmail.com
                Article
                JPBS-14-503
                10.4103/jpbs.jpbs_71_22
                9469312
                580e7f2e-879a-4c48-939d-c5285415fd4f
                Copyright: © 2022 Journal of Pharmacy and Bioallied Sciences

                This is an open access journal, and articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as appropriate credit is given and the new creations are licensed under the identical terms.

                History
                : 12 January 2022
                : 07 March 2022
                Categories
                Original Article

                Pharmacology & Pharmaceutical medicine
                anesthesia,cclad,local anesthesia,pain,palatal anesthesia,pediatric dentistry,visual analog scale,wand

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