Journal of Dental Anesthesia and Pain Medicine

The Korean Dental Society of Anesthsiology (대한치과마취과학회)
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Efficacy of computer-controlled local anesthesia delivery system on pain in dental anesthesia: a systematic review of randomized clinical trials

  • Maryam Altuhafy (Department of Orofacial Pain and TMJ Disorders, Eastman Institute for Oral Health, University of Rochester) ;
  • Gurinder Singh Sodhi (Department of Orofacial Pain and TMJ Disorders, Eastman Institute for Oral Health, University of Rochester) ;
  • Junad Khan (Department of Orofacial Pain and TMJ Disorders, Eastman Institute for Oral Health, University of Rochester)
  • Received : 2024.07.02
  • Accepted : 2024.07.22
  • Published : 2024.08.01
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Abstract

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.

Keywords

Acknowledgement

We thank the Division of Orofacial Pain for providing us the opportunity to conduct this systematic review.

References

  1. Kwak EJ, Pang NS, Cho JH, Jung BY, Kim KD, Park W. Computer-controlled local anesthetic delivery for painless anesthesia: a literature review. J Dent Anesth Pain Med 2016; 16: 81-8.  https://doi.org/10.17245/jdapm.2016.16.2.81
  2. Ghoshal NK, Singh S. Computer controlled local anaesthesia delivery (CCLAD) system WandⓇSTA, SleeperOneⓇ, DentapenⓇ - electronically programmed injection devices; a cutting edge technology for painless dental anesthesia - a mini review. EJASET 2023; 1: 14-9. 
  3. Malamed SF. Local anesthesia. J Calif Dent Assoc 1998; 26: 657, 660. 
  4. Saloum FS, Baumgartner JC, Marshall G, Tinkle J. A clinical comparison of pain perception to the Wand and a traditional syringe. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2000; 89: 691-5.  https://doi.org/10.1067/moe.2000.106333
  5. Saxena P, Gupta SK, Newaskar V, Chandra A. Advances in dental local anesthesia techniques and devices: an update. Natl J Maxillofac Surg 2013; 4: 19-24.  https://doi.org/10.4103/0975-5950.117873
  6. Libonati A, Nardi R, Gallusi G, Angotti V, Caruso S, Coniglione F, et al. Pain and anxiety associated with computer-controlled local anaesthesia: systematic review and meta-analysis of cross-over studies. Eur J Paediatr Dent 2018; 19: 324-32. 
  7. Page MJ, McKenzie JE, Bossuyt PM, Boutron I, Hoffmann TC, Mulrow CD, et al. The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. BMJ 2021; 372: n71. 
  8. Anil O, Keskin G. Comparison of computer controlled local anesthetic delivery and traditional injection regarding disruptive behaviour, pain, anxiety and biochemical parameters: a randomized controlled trial. J Clin Pediatr Dent 2024; 48: 120-7. 
  9. Attia S, Austermann T, May A, Mekhemar M, Conrad J, Knitschke M, et al. Pain perception following computer-controlled versus conventional dental anesthesia: randomized controlled trial. BMC Oral Health 2022; 22: 425. 
  10. Flisfisch S, Woelber JP, Walther W. Patient evaluations after local anesthesia with a computer-assisted method and a conventional syringe before and after reflection time: a prospective randomized controlled trial. Heliyon 2021; 7: e06012. 
  11. Helmy RH, Zeitoun SI, El-Habashy LM. Computer-controlled intraligamentary local anaesthesia in extraction of mandibular primary molars: randomised controlled clinical trial. BMC Oral Health. 2022; 22: 194. 
  12. Ludovichetti FS, Zuccon A, Zambon G, Pellegrino G, Signoriello AG, Milia E, et al. Pain perception in paediatric patients: evaluation of computerised anaesthesia delivery system vs conventional infiltration anaesthesia in paediatric patients. Eur J Paediatr Dent 2022; 23: 153-6. 
  13. O'Neal LY, Nusstein J, Drum M, Fowler S, Reader A, Ni A. Comparison of maxillary lateral incisor infiltration pain using the dentapen and a traditional syringe: a prospective randomized study. J Endod 2022; 48: 840-4.  https://doi.org/10.1016/j.joen.2022.04.008
  14. Prol Castelo A, Garcia Mato E, Varela Aneiros I, Sande Lopez L, Outumuro Rial M, Abeleira Pazos MT, et al. Evaluation of intraligamentous and intraosseous computer-controlled anesthetic delivery systems in pediatric dentistry: a randomized controlled trial. Children (Basel). 2022; 10: 79. 
  15. Shetty S, Dalvi S, Katge F, Patil D, Chimata VK, Shetty A. Comparison of pain perception between computer-controlled local anesthetic delivery and the conventional syringe for inferior alveolar nerve block in children. Dent Med Probl 2022; 59: 523-9.  https://doi.org/10.17219/dmp/135897
  16. de Camargo Smolarek P, da Silva LS, Martins PRD, da Cruz Hartman K, Bortoluzzi MC, Chibinski ACR. The influence of distinct techniques of local dental anesthesia in 9- to 12-year-old children: randomized clinical trial on pain and anxiety. Clin Oral Investig 2021; 25: 3831-43.  https://doi.org/10.1007/s00784-020-03713-7
  17. Dempsy Chengappa MM, Prashanth AK. Evaluation of efficacy of computer-controlled local anaesthetic delivery system vs traditional injection system for minor pediatric surgical procedures in children. Med J Armed Forces India 2022; 78: S89-95.  https://doi.org/10.1016/j.mjafi.2020.08.010
  18. Berrendero S, Hriptulova O, Salido MP, Martinez-Rus F, Pradies G. Comparative study of conventional anesthesia technique versus computerized system anesthesia: a randomized clinical trial. Clin Oral Investig 2021; 25: 2307-15.  https://doi.org/10.1007/s00784-020-03553-5
  19. Vitale MC, Gallo S, Pascadopoli M, Alcozer R, Ciuffreda C, Scribante A. Local anesthesia with SleeperOne S4 computerized device vs traditional syringe and perceived pain in pediatric patients: a randomized clinical trial. J Clin Pediatr Dent 2023; 47: 82-90. 
  20. Beegum F, Monier E, Elshaboury SN, Alghofaili AI, Habibullah MA, Karthika S. Comparison of automatically controlled injection system with a traditional. Syringe for multiple infiltrations in children aged 6-12 years: a randomized controlled trial. J Pharm Bioallied Sci 2024; 16(Suppl 2): S1535-8.  https://doi.org/10.4103/jpbs.jpbs_1214_23
  21. Muller-Bolla M, Aiem E, Joseph C, Davit-Beal T, Marquillier T, Esclassan E, et al. Pain during primary molar local anaesthesia with SleeperOne5 computerized device versus conventional syringe: a randomized, split-mouth, crossover, controlled trial. Int J Paediatr Dent 2024. 
  22. Jorgensen L, Paludan-Muller AS, Laursen DR, Savovic J, Boutron I, Sterne JA, et al. Evaluation of the Cochrane tool for assessing risk of bias in randomized clinical trials: overview of published comments and analysis of user practice in Cochrane and non-Cochrane reviews. Syst Rev 2016; 5: 80. 
  23. Reddy R, Upadya VH, Sequeira JP, Chandra J. A randomised split-mouth clinical trial to assess the efficacy of oroquiver: an affordable vibrotactile device for dental injections. J Clin Diagn Res 2024; 18: 46-9.  https://doi.org/10.7860/JCDR/2024/64742.18950
  24. Tirupathi SP, Nanda N, Pallepagu S, Malothu S, Rathi N, Chauhan RS, et al. The combined effect of extraoral vibratory stimulus and external cooling on pain perception during intra-oral local anesthesia administration in children: a systematic review and meta-analysis. J Dent Anesth Pain Med 2022; 22: 87-96.  https://doi.org/10.17245/jdapm.2022.22.2.87
  25. Grace EG, Barnes DM, Macek MD, Tatum N. Patient and dentist satisfaction with a computerized local anesthetic injection system. Compend Contin Educ Dent 2000; 21: 746-8, 750, 752. 
  26. Berrendero S, Hriptulova O, Salido MP, Martinez-Rus F, Pradies G. Comparative study of conventional anesthesia technique versus computerized system anesthesia: a randomized clinical trial. Clin Oral Investig 2021; 25: 2307-15.  https://doi.org/10.1007/s00784-020-03553-5
  27. Thoppe-Dhamodhara YK, Asokan S, John BJ, Pollachi-Ramakrishnan G, Ramachandran P, Vilvanathan P. Cartridge syringe vs computer controlled local anesthetic delivery system: pain related behaviour over two sequential visits - a randomized controlled trial. J Clin Exp Dent 2015; 7: e513-8.  https://doi.org/10.4317/jced.52542
  28. Akinmoladun VI, Okoje VN, Akinosun OM, Adisa AO, Uchendu OC. Evaluation of the haemodynamic and metabolic effects of local anaesthetic agent in routine dental extractions. J Maxillofac Oral Surg 2013; 12: 424-8.  https://doi.org/10.1007/s12663-012-0449-4
  29. Meyer FU. Haemodynamic changes under emotional stress following a minor surgical procedure under local anaesthesia. Int J Oral Maxillofac Surg 1987; 16: 688-94.  https://doi.org/10.1016/S0901-5027(87)80054-1
  30. Tolas AG, Pflug AE, Halter JB. Arterial plasma epinephrine concentrations and hemodynamic responses after dental injection of local anesthetic with epinephrine. J Am Dent Assoc 1982; 104: 41-3.  https://doi.org/10.14219/jada.archive.1982.0114
  31. Meechan JG, Parry G, Rattray DT, Thomason JM. Effects of dental local anaesthetics in cardiac transplant recipients. Br Dent J 2002; 192: 161-3.  https://doi.org/10.1038/sj.bdj.4801323
  32. Ozer S, Yaltirik M, Kirli I, Yargic I. A comparative evaluation of pain and anxiety levels in 2 different anesthesia techniques: locoregional anesthesia using conventional syringe versus intraosseous anesthesia using a computer-controlled system (Quicksleeper). Oral Surg Oral Med Oral Pathol Oral Radiol 2012; 114: S132-9.  https://doi.org/10.1016/j.oooo.2011.09.021
  33. Goyal R, Nandlal B. Pain perception and procedural tolerance with computer controlled and conventional local anesthetic technique: an in vivo comparative study. Indian J Pain 2014; 28: 143-8.  https://doi.org/10.4103/0970-5333.138441
  34. Smolarek PC, da Silva LS, Martins PRD, Hartman KDC, Bortoluzzi MC, Chibinski ACR. Evaluation of pain, disruptive behaviour and anxiety in children aging 5-8 years old undergoing different modalities of local anaesthetic injection for dental treatment: a randomised clinical trial. Acta Odontol Scand 2020; 78: 445-53.  https://doi.org/10.1080/00016357.2020.1757752
  35. Aggarwal K, Lamba AK, Faraz F, Tandon S, Makker K. Comparison of anxiety and pain perceived with conventional and computerized local anesthesia delivery systems for different stages of anesthesia delivery in maxillary and mandibular nerve blocks. J Dent Anesth Pain Med 2018; 18: 367-73. https://doi.org/10.17245/jdapm.2018.18.6.367