Article Data

  • Views 982
  • Dowloads 229

Systematic reviews

Open Access

Pain and Anxiety Levels Using Conventional versus Computer-Controlled Local Anesthetic Systems in Pediatric Patients: A Meta-Analysis

  • Amaury Pozos-Guillén1
  • Edith Loredo-Cruz1
  • Vicente Esparza-Villalpando1
  • Ricardo Martínez-Rider2
  • Miguel Noyola-Frías2
  • Arturo Garrocho-Rangel1,*,

1Pediatric Dentistry Postgraduate Program, Faculty of Dentistry, San Luis Potosí University, San Luis Potosí, SLP, Mexico

2Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, San Luis Potosí University, San Luis Potosí, SLP, Mexico

DOI: 10.17796/1053-4625-44.6.1 Vol.44,Issue 6,November 2020 pp.371-399

Published: 01 November 2020

*Corresponding Author(s): Arturo Garrocho-Rangel E-mail: agarrocho@hotmail.com

Abstract

The objective of this systematic review and meta-analysis was to compare the pain/anxiety levels associated with the anesthetic process by conventional and computer-controlled delivery systems (CCDS) in children. Four electronic databases (PubMed, EMBASE, Scopus, Google Scholar, and Dentistry & Oral Science Source/EBSCO) were comprehensively explored for eligible studies, in English or Spanish, published from January 1995 to December 2019. A systematic literature review and meta-analysis were conducted according to the PRISMA statement, including only randomized controlled clinical trials. An exhaustive search was performed in different electronic databases under a specific PICO-posed question. Relevant studies were selected based on titles and abstracts, and the full texts were retrieved. From these articles, important information was extracted. Wand demonstrated significantly lower pain than the conventional injection did. In the subgroup by pain scale analysis, the Facial Image Scale and Wong-Baker Faces Pain Scale showed a significant difference in favor of the CCDS. In general, the reviewed evidence shows that less perceived pain and anxiety occur when the local anesthetic technique is performed with a CCDS than with the traditional technique.

Keywords

Local anesthesia; Injection syringe; Wand; Computerized methods; Pediatric dentistry; Systematic review; Meta-analysis

Cite and Share

Amaury Pozos-Guillén,Edith Loredo-Cruz,Vicente Esparza-Villalpando,Ricardo Martínez-Rider, Miguel Noyola-Frías,Arturo Garrocho-Rangel. Pain and Anxiety Levels Using Conventional versus Computer-Controlled Local Anesthetic Systems in Pediatric Patients: A Meta-Analysis. Journal of Clinical Pediatric Dentistry. 2020. 44(6);371-399.

References

1. Gibson RS, Allen K, Hutfless S, Beiraghi S. The Wand vs. traditional injection: A comparison of pain related behaviors. Pediatr Dent; 22: 458–462, 2000.

2. Gaglani A, Gross T. Pediatric pain management. Emerg Med Clin N Am; 36: 323–334, 2018.

3. Jälevik B, Klingberg G. Pain sensation and injection techniques in maxillary dento-alveolar surgery procedures in children – A comparison between conventional and computerized injection techniques (The Wand®). Swed Dent J; 38: 67–75, 2014.

4. Allen KD, Kotil D, Larzelere RE, Hutfless S, Beiraghi S. Comparison of a computerized anesthesia device with a traditional syringe in preschool children. Pediatr Dent; 24: 315–320, 2002.

5. Klein U, Hunzeker C, Hutfless S, Galloway A. Quality of anesthesia for the maxillary primary anterior segment in pediatric patients: Comparison of the P-ASA nerve block using CompuMed delivery system vs traditional supraperiosteal injections. J Dent Child; 72: 119–125, 2005.

6. Mittal M, Kumar A, Srivastava D, Sharma P, Sharma S. Pain perception: Computerized versus traditional local anesthesia in pediatric patients. J Clin Pediatr Dent; 39: 470–474, 2015.

7. Libonati A, Nardi R, Gallusi G, Angotti V, Caruso S, Coniglione F. Pain and anxiety associated with computer-controlled local anaesthesia: systematic review and meta-analysis of cross-over studies. Eur J Paediatr Dent; 19: 324–332, 2018.

8. de Camargo-Smolarek PC, Wambier LM, Siqueira-Silva L, Chibinski ACR. Does computerized anesthesia reduce pain during local anaesthesia in paediatric patients for dental treatment? A systematic review and meta-analysis. Int J Paediatr Dent; 30: 118–135, 2020.

9. Feda M, Al Amoudi N, Sharaf A, Hanno A, Farse N, Masoud I, Almushyt A. A comparative study of children’s pain reactions and perceptions to AMSA injection using CCLAD versus traditional injections. J Clin Pediatr Dent; 34: 217–222, 2010.

10. Liberati A, Altman DG, Tetzlaff J, Mulrow C, Gotzsche PC, Loannidis JP, Clarke M, Devereaux PJ, Kleijnen J, Moher D. The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate health care interventions: Explanation and elaboration. J Clin Epidemiol; 62: e1–e34, 2009.

11. Moher D, Shamseer L, Clarke M, Ghersi D, Liberati A, Petticrew M, Shekelle P, Stewart LA, PRISMA-P Group. Preferred reporting items for systematic review and meta-analysis protocols (PRISMA-P) 2015 statement. Syst Rev; 4: 1–9, 2015.

12. Higgins J, Green S. Cochrane Handbook for Systematic Reviews of Interventions Version 5.1.0. 5.1 ed. John Wiley & Sons, Ltd.; 614, 2011.

13. OCEBM. Explanation of the 2011 Oxford Centre for Evidence-Based Medicine (OCEBM) levels of evidence. Available at: https://www.cebm. net/2011/06/explanation-2011-ocebm-levels-evidence/. [Date accessed: February 15, 2020].

14. Pozos-Guillén A, García-Flores A, Esparza-Villalpando V, Garrocho-Rangel A. Intracanal irrigants for pulpectomy in primary teeth: A systematic review and meta-analysis. Int J Paediatr Dent; 26: 412–425, 2016.

15. Al Amoudi N, Feda M, Sharaf A, Hanno A, Farsi N. Assessment of the anesthetic effectiveness of anterior and middle superior alveolar injection using a computerized device versus traditional technique in children. J Clin Pediatr Dent; 33: 97–102, 2008.

16. Alamoudi NM, Baghlaf KK, Elashiry EA, Farsi NM, El Derwi DA, Bayoumi AM. The effectiveness of computerized anesthesia in primary mandibular molar pulpotomy: A randomized controlled trial Quintessence Int; 47: 217–224, 2016.

17. Asarch T, Allen K, Petersen B, Beiraghi S. Efficacy of a computerized local anesthesia device in pediatric dentistry. Pediatr Dent; 21: 421–424, 1999.

18. Baghlaf K, Alamoudi N, Elashiry E, Farsi N, El Derwi DA, Abdullah AM. The pain-related behavior and pain perception associated with computerized anesthesia in pulpotomies of mandibular primary molars: A randomized controlled trial. Quintessence Int; 46: 799–806, 2015.

19. Deepak V, Reddy-Challa R, Kamatham R, Nuvvula S. Comparison of a new auto-controlled injection system with traditional syringe for mandibular infiltration in children: A randomized clinical trial. Anesth Essays Res; 11: 431–438, 2017.

20. Garret-Bernardin A, Cantile T, D’Anto V, Galanakis A, Fauxpoint G, Ferrazzano GF, De Rosa S, Vallogini G, Romeo U, Galeotti A. Pain experience and behavior management in pediatric dentistry: A comparison between traditional local anesthesia and the Wand computerized delivery system. Pain Res Manag; 2017: 1–7, 2017.

21. Goyal R, Nandlal B, Prashanth. Pain perception and procedural tolerance with computer controlled and conventional local anesthetic technique: An in vivo comparative study. Ind J Pain; 28: 143–148, 2014.

22. Kandiah P, Tahmassebi JF. Comparing the onset of maxillary infiltration local anaesthesia and pain experience using the conventional technique vs. the Wand in children. Br Dent J; 213: E1–E5, 2012.

23. Koyuturk AE, Avsar A, Sumer M. Efficacy of dental practitioners in injection techniques: Computerized device and traditional syringe. Quintessence Int; 40: 73–77, 2009.

24. Kusku OO, Akyuz S. Is the injection device or the anxiety experienced that causes pain during dental local anesthesia? Int J Paediatr Dent; 18: 139–145, 2008.

25. Langthasa M, Yeluri R, Jain AA, Munshi AK. Comparison of the pain perception in children using comfort control syringe and a conventional injection technique during pediatric dental procedures. J Ind Soc Pedod Pediatr Dent; 30: 323–328, 2012.

26. Maldonado-Ramírez MA, Reyes-Flores R, Isassi-Hernández H, AzuaraFlores EE. Conventional dental anesthesia vs computer-controlled dental anesthesia: Experimental study. Int J Curr Res; 9: 53985–53988, 2017.

27. Mittal M, Chopra R, Kumar A, Srivastava D. Comparison of pain perception using conventional versus computer-controlled intraligamentary local anesthetic injection for extraction of primary molars. Anesth Prog; 66: 69–76, 2019.

28. Palm AM, Kirkegaard U, Poulsen S. The Wand versus traditional injection for mandibular nerve block in children and adolescents: Perceived pain and time of onset. Pediatr Dent; 26: 481–484, 2004.

29. Patini R, Staderini F, Cantiani M, Camodeca A, Guclielmi F, Gallenzi P. Dental ansesthesia for children – effects of a computer-controlled delivery system on pain and heart rate: A randomized clinical trial. Brit J Oral Maxillofac Surg; 56: 744–749, 2018.

30. Queiroz AM, Carvalho AB, Censi LL, et al. Stress and anxiety in children after the use of computerized dental anesthesia. Braz Dent J; 26: 303–307, 2015.

31. Ram D, Peretz B. The assessment of pain sensation during local anesthesia using a computerized local anesthesia (Wand) and a conventional syringe. J Dent Child; 70: 130–133, 2003.

32. Ram D, Kassirer J. Assessment of a palatal approach-anterior superior alveolar (P-ASA) nerve block with the Wand® in paediatric dental patients. Int J Paediatr Dent; 16: 348–351, 2006.

33. San Martín-López AL, Garrigos-Esparza LD, Torre-Delgadillo G, Gordillo-Moscoso A, Hernandez-Sierra JF, Pozos-Guillén AJ. Clinical comparison of pain perception rates between computerized local anesthesia and conventional syringe in pediatric patients. J Clin Pediatr Dent; 29: 239–243, 2005.

34. Tahmassebi JF, Nikolaou M, Duggal MS. A comparison of pain and anxiety associated with the administration of maxillary local analgesia with Wand and conventional technique. Eur Arch Paediatr Dent; 10: 77–82, 2009.

35. Versloot J, Veerkamp JSJ, Hoogstraten J. Computerized anesthesia delivery system vs. traditional syringe: comparing pain and pain-related behavior in children. Eur J Oral Sci; 113: 488–493, 2005.

36. Versloot J, Veerkamp JSJ, Hoogstraten. Pain behaviour and distress in children during two sequential dental visits: comparing a computerised anaesthesia delivery system and a traditional syringe. Brit Dent J; 205: E2; discussion 30–31, 2008.

37. Yogesh-Kumar TD, Jhon JB, Asokan S, Geetha Priya PR, Punithavathy R, Praburajan V. Behavioral response and pain perception to computer controlled local anesthesia delivery system and cartridge syringe. J Ind Soc Pedod Prev Dent; 33: 223–228, 2015.

38. Yogesh-Kumar TD, Asokan S, John BJ, Pollachi-Ramakrishnan G, Ramachandran 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; 7: e513–e518, 2015.

39. Ching D, Finkelman M, Loo CY. Effect of the DentalVibe injection system on pain during local anesthesia injection in adolescent patients. Pediatr Dent; 36: 51–55, 2014.

40. Elbay M, Sermet-Elbay U, Yildirim S, Ugurluel C, Kaya C, Baydemir C. Comparison of injection pain caused by the DentalVibe injection system versus a traditional syringe for inferior alveolar nerve block anaesthesia in paediatric patients. Eur J Paediatr Dent; 16: 123–128, 2015.

41. Raslan N, Masri R. A randomized clinical trial to compare pain levels during three types of oral anesthetic injections and the effect of DentalVibe® on injection pain in children. Int J Paediatr Dent; 28: 102–110, 2018.

42. Roeber B, Wallace DP, Rothe V, Salama F, Allen KD. Evaluation of the effects of the VibraJect attachment on pain in children receiving local anesthesia. Pediatr Dent; 33: 46–50, 2011.

43. Şermet Elbay Ü, Elbay M, Yıldırım S, Kaya C, Ugurluel C, Baydemir C. Evaluation of the injection pain with the use of DentalVibe injection system during supraperiosteal anaesthesia in children: a randomised clinical trial. Int J Paediatr Dent; 26: 336–345, 2016.

44. Tung J, Carillo C, Udin R, Wilson M, Tanbonliong T. Clinical performance of the DentalVibe® injection system on pain perception during local anesthesia in children. J Dent Child; 85: 51–57, 2018.

45. Bansal N, Saha S, Jaiswai JN, Samadi F. Pain elimination during injection with newer electronic devices: A comparative evaluation in children. Int J Clin Pediatr Dent; 7: 71–76, 2014.

46. Choudhari SR, Solanki PJ, Vispute GK, Goyal SP, Bharti KD, Verma BS. Efficacy of transcutaneous electronic nerve stimulation in alleviating pain during inferior alveolar nerve block injections in pediatric dentistry. Int J Pedodont Rehabil; 2: 69–72, 2017.

47. Nieuwenhizen J, Hembrecht EJ, Artman IH, Krikken J, Veerkamp JS. Comparison of two computerized anaesthesia delivery systems: pain and pain-related behaviour in children during a dental injection. Eur Arch Paediatr Dent; 14: 9–13, 2013.

48. Oztas N, Ulusu T, Bodur H, Dogan C. The Wand in pulp therapy: An alternative to inferior alveolar nerve block. Quintessence Int; 36: 559–564, 2005.

49. Ran D, Peretz B. Assessing the pain reaction of children receiving periodontal ligament anesthesia using a computerized device (Wand). J Clin Pediatr Dent; 27: 247–250, 2003.

50. Şermet Elbay Ü, Elbay M, Kaya C, Ugurluel C, Baydemir C. The efficacy of DentalVibe injection comfort system producing vibration impulse to reduce injection pain of palatal local infiltration anesthesia in children. Turkiye Klinikleri J Dental Sci; 21: 207–215, 2015.

51. Smaïl-Faugeron V, Muller-Bolla M, Jean-Luis S, Courson F. Evaluation of intraosseous computerized injection system (QuickSleeper™) vs conventional infiltration anaesthesia in paediatric oral health care: A multicentre, single‐blind, combined split‐mouth and parallel‐arm randomized controlled trial. Int J Paediatr Dent; 29: 573–584, 2019.

52. van Dinter N, van Maanen EJ, Versloot J. Children’s discomfort while giving local anesthesia Comparison of an automated system and traditional method. Ned Tijdschr Tandheelkd; 4: 137–141, 2006.

53. Zhao QM, Hongling XL. Application of local anesthesia injection system under computer control in children. West China J Stomatol; 29: 1–5, 2011.

54. Yesilyurt C, Bulut G, Taşdemir T. Pain perception during inferior alveolar injection administered with the Wand or conventional syringe. Br Dent J; 205: E10; discussion 258–259, 2008.

55. Sivaramakrishnan G, Sridharan K, Local anaesthetic drug administration in dentistry using computer assisted anaesthetic delivery system: a systematic review. Open Dent J; 10: 454–459, 2016.

56. 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; 16: 81–88, 2016.

57. Kahsay H. Assessment and treatment of pain in pediatric patients. Curr Pediatr Res; 21: 148–157, 2017.

58. Baghlaf K, Elashiry E, Alamoudi N. Computerized intraligamental anesthesia in children: A review of clinical considerations. J Dent Anesth Pain Med; 18: 194–204, 2018.


Abstracted / indexed in

Science Citation Index Expanded (SciSearch) Created as SCI in 1964, Science Citation Index Expanded now indexes over 9,500 of the world’s most impactful journals across 178 scientific disciplines. More than 53 million records and 1.18 billion cited references date back from 1900 to present.

Biological Abstracts Easily discover critical journal coverage of the life sciences with Biological Abstracts, produced by the Web of Science Group, with topics ranging from botany to microbiology to pharmacology. Including BIOSIS indexing and MeSH terms, specialized indexing in Biological Abstracts helps you to discover more accurate, context-sensitive results.

Google Scholar Google Scholar is a freely accessible web search engine that indexes the full text or metadata of scholarly literature across an array of publishing formats and disciplines.

JournalSeek Genamics JournalSeek is the largest completely categorized database of freely available journal information available on the internet. The database presently contains 39226 titles. Journal information includes the description (aims and scope), journal abbreviation, journal homepage link, subject category and ISSN.

Current Contents - Clinical Medicine Current Contents - Clinical Medicine provides easy access to complete tables of contents, abstracts, bibliographic information and all other significant items in recently published issues from over 1,000 leading journals in clinical medicine.

BIOSIS Previews BIOSIS Previews is an English-language, bibliographic database service, with abstracts and citation indexing. It is part of Clarivate Analytics Web of Science suite. BIOSIS Previews indexes data from 1926 to the present.

Journal Citation Reports/Science Edition Journal Citation Reports/Science Edition aims to evaluate a journal’s value from multiple perspectives including the journal impact factor, descriptive data about a journal’s open access content as well as contributing authors, and provide readers a transparent and publisher-neutral data & statistics information about the journal.

Scopus: CiteScore 2.0 (2022) Scopus is Elsevier's abstract and citation database launched in 2004. Scopus covers nearly 36,377 titles (22,794 active titles and 13,583 Inactive titles) from approximately 11,678 publishers, of which 34,346 are peer-reviewed journals in top-level subject fields: life sciences, social sciences, physical sciences and health sciences.

Submission Turnaround Time

Conferences

Top