Local anesthesia with SleeperOne S4 computerized device vs traditional syringe and perceived pain in pediatric patients: a randomized clinical trial.

Local anesthesia is performed in dentistry before clinical procedures to avoid pain. Children can show fear at the sight of the needle and pain at its insertion. To make local anesthesia more comfortable, the use of computer-controlled local anesthetic delivery (CCLAD) systems has been developed to control the flow rate of the anesthetic solution injected through the needle. The aim of the present research is to evaluate and compare the discomfort felt by patients using a traditional syringe and the CCLAD system SleeperOne®, by considering pain, size sensation, bitterness, and vomit. 30 patients were included in the study and randomly assigned to traditional anesthesia or CCLAD. After injection, patients were assessed for the abovementioned outcomes. A Visual Analogue Scale (VAS) from 0 to 10 scores was used. As far as pain is concerned, statistically lower mean values were found in the Trial group (p < 0.05). Instead, concerning size, bitterness and vomit perceptions, no statistically significant differences were found between the groups (p > 0.05). Linear regressions were calculated considering technique, quadrant, dental arch, tooth, dentition, sex, and age as independent variables. The technique has shown to have a significant influence on pain (p < 0.05), with lower values for SleeperOne® device. Pain resulted significantly influenced by the type of dentition (p < 0.05), with higher scores for deciduous one. Moreover, perceived pain decreased with the increase of the age of patients (p < 0.05). At last, bitterness perception scores resulted to be higher for primary first molars (p < 0.05). SleeperOne® device seems to be a valid support for the reduction of pain related to anesthetic injection, especially in children. Further studies should evaluate CCLADs' uses combined with lidocaine preanesthetic as well as with conscious sedation through nitrous oxide in order to determine possible synergistic effects between these procedures.

Photobiomodulation and Pain Reduction in Patients Requiring Orthodontic Band Application: Randomized Clinical Trial.

PURPOSE: The aim of this study was to investigate the effect of Photobiomodulation (PBM) in managing orthodontic pain intensity over time in patients requiring band application on upper first molars. METHODS: Maxillary first molars were banded. In the trial group, each molar received single-session PBM on two buccal and two palatal points (λ = 830 ± 10 nm; 150 mW, 7.5 J/cm2; spot of 0.1 cm2; 5 sec per point), while the control group received a placebo treatment. All patients were asked to answer five pain rating scales to assess pain intensity at 5 minutes and 1, 12, 24, and 72 hours and completed a survey describing the type of pain and its temporal course in the next 7 days. RESULTS: 26 patients (mean age 11.8 years) were randomly assigned to a control or a trial group. The trial group showed significantly lower pain intensities (p < 0.05) at 5 min (M = 0.92, SD = 1.32), 1 h (M = 0.77, SD = 1.01), and 12 h (M = 0.77, SD = 1.54) after band application compared to the control group (5 min: M = 1.62, SD = 1.26; 1 h: M = 1.77, SD = 1.92; and 12 h: M = 1.77, SD = 2.17), whereas no difference between groups (p > 0.05) was found at 24 h (trial: M = 0.62, SD = 1.71; control: M = 1.08, SD = 1.75) and 72 h (trial: M = 0.31, SD = 0.75; control: M = 0.15, SD = 0.55). Patients in the control group reported more frequently the presence of "compressive pain" (58.8%, p < 0.05) from the appliance during the week after the application, while the trial group showed higher frequency of "no pain" (46.2%, p < 0.05). However, PBM did not affect the pain onset (trial: M = 10.86, SD = 26.97; control: M = 5.25, SD = 7.86), peak (trial: M = 15.86, SD = 26.29; control: 6.17, SD = 7.96), and end time (trial: 39.57, SD = 31.33; control: M = 22.02, SD = 25.42) reported by the two groups (p > 0.05). CONCLUSIONS: PBM might be considered a promising alternative to decrease general pain intensity, although not affecting the typical pain cycle, in terms of the onset, peak, and ending times.