• Journal of The Korean Dental Society of Anesthesiology
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• v.13 no.4
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• pp.179-188
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• 2013

Background: Today, there are computer controlled local anesthesia devices used clinically. The main principle is to control injection speed by computer aided system, and it relieves pain. However, there are few objective data considering this subject. In this literature review, we researched studies about computer controlled anesthetic delivery. We compared pain control effect of computer controlled to conventional local anesthetic syringe system. Methods: A bibliographic search in PubMed was performed and we reviewed original articles. Results: There were 18 publications that compared pain control effect of computer controlled to conventional system. There were 8 articles reported of children, similar pain control effect was found in 7 of them. One study showed superior pain control effect of computer controlled anesthetic delivery. For adults, 10 studies showed superior pain control effect in computer aided system. Conclusions: Computer controlled anesthetic delivery has similar or superior pain control effect compared to conventional local anesthetic syringe system. For both children and adults, computer controlled anesthetic delivery could be clinically useful, still it may be more effective for adults.

• Journal of the Korean Academy of Clinical Electrophysiology
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• v.1 no.2
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• pp.11-19
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• 2003

The purpose of this study investigated the anesthetic effects of lidocaine gel by phonophoretic transdermal delivery. The anesthetic effects were evaluated by two aspects as quantitative sensory testing and sensory nerve conduction study. Twelve healthy males(aged $23.25{\pm}2.09$ years) were studied. Exclusion criteria were ; pain, history of sensory disturbances and skin conditions in the areas to be examined. The subjects were divided into two groups; group I(lidocaine gel without ultrasound) and group II(lidocaine gel with ultrasound). The following results were obtained; 1. In changes of tactile threshold and electrical pain threshold, all groups were significantly increased(p<0.05). 2. In changes of electrical pain threshold, it was significantly differenced between the groups(p<0.05). We conclude that the transdermal delivery of lidocaine gel by phonophoresis has a possibility to use for surface anesthesia and the pain control of the superficial tissue.

• Journal of Dental Anesthesia and Pain Medicine
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• v.18 no.6
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• pp.367-373
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• 2018

Background: Fear of local anesthesia (LA) is a significant impediment to dental care as many patients delay or avoid treatment to avert pain. Computer-controlled local anesthetic delivery system (CCLAD), with constant and controlled rate of flow, present a painless alternative. The present study aimed to compare anxiety and pain perceived with conventional and computerized systems, for different stages of anesthesia delivery when administering various nerve blocks. Methods: One hundred patients requiring bilateral LA participated in the study. One side was anesthetized using one system and the contralateral side was anesthetized using the other, in two separate appointments. Patients assigned anxiety scores on a 5-point scale and used the visual analogue scale (VAS) for pain determination at needle insertion, during delivery of anesthetic solution, immediately after injection, and at the end of the periodontal procedure. Each patient's preference for the delivery system of future injections was also recorded. Results: Patients reported significantly lower anxiety levels with CCLAD compared to the syringe. Significantly lower mean VAS scores for anesthesia deposition, pain immediately after, and at the end of the periodontal procedure were also noted. However, pain at needle insertion was comparable between the two systems, with no statistical significance. Overall, 64.4% patients preferred CCLAD for future anesthesia. Conclusion: Lower pain perceived with CCLAD and higher preference for the system suggest that CCLAD should replace conventional syringes to allow pain-free dental treatment.

• Journal of Dental Anesthesia and Pain Medicine
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• v.16 no.2
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• pp.81-88
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• 2016

Local anesthesia is administered to reduce pain during dental treatments, but may itself cause pain and contribute to increased dental fear. Computer-controlled local anesthetic delivery (CCLAD) is one the method to reduce patient pain during local anesthesia; it is a device that slowly administers anesthetics by using a computerized device to control the injection speed. This literature review aims to provide an objective assessment of the usefulness of CCLAD for controlling pain by reviewing papers published to date that have used CCLAD.

• Journal of Dental Anesthesia and Pain Medicine
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• v.19 no.3
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• pp.135-141
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• 2019

Background: The fear of needle insertion and pain during anesthesia is a source of patient dissatisfaction in dentistry. Inferior alveolar nerve block (IANB) remains the most common type of block and is in itself painful. Computer-controlled local anesthetic delivery (CCLAD) has been proven to reduce the pain associated with injection of anesthetics in various blocks. However, the efficacy of CCLAD for IANB in adults remains unknown. Methods: Sixty-four adult patients requiring bilateral IANB were selected and divided into two groups: group A (50 patients receiving IANB via CCLAD) and group B (50 patients receiving IANB using a conventional cartridge syringe). Pain perception and patient comfort were assessed using the visual analog scale and the 5-point semantic scale, respectively. Results: The pain perception was compared between the two groups using the Mann-Whitney U-test, and the P value was 0.003. The patient comfort was also compared using the same test, and the P value was 0.484. Conclusion: A significant difference was observed in the pain perception of the patients during CCLAD. The patient comfort was grossly equal for both techniques.

• Journal of Dental Anesthesia and Pain Medicine
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• v.18 no.2
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• pp.89-95
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• 2018

Background: Incorrect administration of an anesthetic during local anesthesia is one of the most important causes of pain symptoms in patients scheduled for dental procedures. The current study assessed the severity of damage to periodontal tissue following different rates of anesthetic administration. Methods: The research was conducted on 50 outbred male rats with a body mass of 180-240 g. The anesthetic used was 1% articaine. Results: The results showed that administration of the anesthetic at a rapid pace caused structural damage to the periodontal tissue. Further, signs of impaired microcirculation were noted at all rates of administration. Biochemical studies demonstrated changes in the level of glucose and enzymes with the rapid introduction of the anesthetic, indicating severe systemic stress response of the body. Conclusions: Injection of local anesthetic at any rate of introduction induces vascular congestion in the microcirculatory bloodstream and exudative reactions. Rapid introduction of an anesthetic causes progression of structural changes in the gingival tissue.

• The Journal of the Korean dental association
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• v.56 no.1
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• pp.58-65
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• 2018

Dental local anesthesia is important procedure for the elimination of pain during dental treatment. However, the pain during local anesthesia is one of the main source of fear to the patients. The cause of pain during dental local anesthesia includes soft tissue damage during penetration of the oral mucosa, pressure from the spread of the anesthetic solution, temperature of anesthetic solution, low pH of anesthetic solution, and the characteristics of the drug. Several concepts and devices introduced to date to reduce the pain during local anesthesia for dental treatment. In this report, devices that can reduce the pain during local anesthesia will be discussed.

• Journal of Periodontal and Implant Science
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• v.34 no.3
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• pp.639-646
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• 2004

Dental phobia is the most prevalent fear in all age groups, across gender, and in all countries. One of the primary identified sources is the fear of dental injections in the dental phobia or the high dental fear and anxiety groups. The purpose of this study was to clinically evaluate the computer controlled anesthetic device and to compare it with traditional methods of dental anesthetic delivery. Fifty(mean age : 25.6 yrs) systemically and periodontally healthy volunteers participated in this study. The subjects were given contralateral buccal and palatal injections. One side was injected with the computer-controlled anesthetic device with a microprocessor and an electric motor to precisely regulate flow rate during administration : The experimental group. The control side was injected with a standard manual syringe, in which flow rate and pressure are operator-dependent and can't be controlled accurately : The control group. The subjects described their perceived pain experiences with two subjective scales. The results of this study were as follows: 1. The computer-controlled anesthetic device was significantly less painful than conventional syringe injection 2. The female subjects reported more pain than the male subjects. But, there were no statistical differences. 3. The anesthetic effect of both methods did not show any difference. In this study, it may be concluded that pain levels decreased significantly when the computer-controlled anesthetic device was used.

• Journal of Dental Anesthesia and Pain Medicine
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• v.24 no.3
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• pp.161-171
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• 2024

The efficient management of pain and discomfort is essential for successful dental treatment and patient compliance. Dental professionals are commonly evaluated for their ability to perform treatment with minimal patient discomfort. Despite advancements in traditional local dental anesthesia techniques, the pain and discomfort associated with injections remain a concern. This scoping review aims to provide a comprehensive overview of the literature on novel dental anesthetics and associated devices designed to alleviate pain and discomfort during dental procedures. The Joanna Briggs Institute and the Preferred Reporting Items for Systematic reviews and Meta-Analyses Extension for Scoping Reviews guidelines were used to prepare the review. Six databases and two sources of gray literature were searched. This review analyzed 107 sources from 1994 to 2023. Local anesthesia devices were grouped into computer-controlled local anesthetic delivery (CCLAD) systems, intraosseous anesthesia (IOA), vibratory stimulation devices, and electronic dental anesthesia (EDA). CCLAD systems, particularly the Wand and Single-Tooth Anesthesia, have been the most researched, with mixed results regarding their effectiveness in reducing pain during needle insertion compared to traditional syringes. However, CCLAD systems often demonstrated efficacy in reducing pain during anesthetic deposition, especially during palatal injections. Limited studies on IOA devices have reported effective pain alleviation. Vibrating devices have shown inconsistent results in terms of pain reduction, with some studies suggesting their primary benefit is during needle insertion rather than during the administration phase. EDA devices are effective in reducing discomfort but have found limited applicability. These findings suggest that the CCLAD systems reduce injection pain and discomfort. However, the evidence for other devices is limited and inconsistent. The development and research of innovative technologies for reducing dental pain and anxiety provides opportunities for interdisciplinary collaboration and improved patient care in dental practice.

• Journal of Pharmaceutical Investigation
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• v.30 no.4
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• pp.273-278
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• 2000

Several topical preparations containing lidocaine, a widely used local anesthetic agent, have been developed and marketed recently for the treatment of premature ejaculation. In this study, microemulsion(ME)-based hydrogels containing lidocaine were prepared by dispersing ME to hydrogel bases such as Carbopol, sod. alginate, and sod. carboxymethylcellulose. Lidocaine-containing ME was thermodynamically stable over 6 months and had a diameter ranging from 10 to 100 nm. In vitro skin penetration of lidocaine from ME-based hydrogels followed apparent zero-order kinetics. ME-based hydrogel showed higher drug penetration during fifteen minutes after application than alcoholic hydrogel, reference preparation. Tail flick test in rat was introduced to compare in vivo local anesthetic effects of different hydrogels, and the results showed that ME-based hydrogels are superior to other hydrogels. In optical microscopy, recrystallization of lidocaine was observed within 5 min after application of reference hydrogel, but there was no change in ME-based hydrogels even after 30 minnute. These results indicated that ME-based hydrogels had some advantages in skin penetration, anesthetic effect and physical stability compared with alcoholic hydrogels. Finally it is possible to conclude that ME-based hydrogels containing lidocaine is a good topical drug delivery system for the treatment of premature ejaculation.