title: A comparative study of children's pain reactions and perceptions to AMSA injection using CCLAD versus traditional injections.
abstract: Pain control is an important part of dentistry, particularly in pediatric dentistry. Recently, a computer-controlled local anesthetic delivery system (CCLAD) has been developed to reduce pain related to the local anesthetic injection. In conjunction with this technology, a new approach to the anterior and middle superior alveolar nerves (AMSA) has been induced. Studies evaluating the CCLAD in pediatric dentistry showed variable results regarding its use in pediatric dentistry. Further evaluation of this technique is needed to provide sound scientific evidence on the use of the CCLAD at this specific injection site in children.
  
  
  OBJECTIVE
  To assess children's pain reactions and pain perceptions of the AMSA injection using the CCLAD compared to the traditional buccal/palatal injections.
  
  
  METHODS
  Children's pain reactions and perceptions to both techniques were measured in a group of 40 children who received both anesthetic techniques alternatively on two visits. The pain reactions were scored using the SEM scale, whereas the pain perception was evaluated by the Eland color scale. Statistical analysis was carried out using SPSS version 10.0.
  
  
  RESULTS
  The AMSA injection delivered with the CCLAD had significantly lower mean pain reaction scores compared to traditional buccal and palatal injections. The prolonged injection time required for delivering the CCLAD injection had no negative impact on the children. The children's pain perception scores when using the CCLAD were also significantly lower compared to the traditional injection.
  
  
  CONCLUSIONS
  The AMSA injection delivered with the CCLAD was found to be a promising device, and had significantly lower pain reaction and perception scores compared to the traditional buccal and palatal injections.
authors.affiliation: Department of Preventive Dental Sciences, Faculty of Dentistry, King Abdulaziz University, Jeddah 21089, Saudi Arabia.
authors.forename: May
authors.initials: M
authors.lastname: Feda
authors.forename: Najlaa
authors.initials: N
authors.lastname: Al Amoudi
authors.forename: Aly
authors.initials: A
authors.lastname: Sharaf
authors.forename: Azza
authors.initials: A
authors.lastname: Hanno
authors.forename: Najat
authors.initials: N
authors.lastname: Farsi
authors.forename: Ibrahim
authors.initials: I
authors.lastname: Masoud
authors.forename: Abdullah
authors.initials: A
authors.lastname: Almushyt
mesh_terms: D000766:Anesthesia, Dental / Q000295:instrumentation / Q000379:methods*; D000772:Anesthesia, Local / Q000295:instrumentation / Q000379:methods*; D000779:Anesthetics, Local / Q000008:administration & dosage*; D002648:Child; D003201:Computers; D016503:Drug Delivery Systems; D004837:Epinephrine / Q000008:administration & dosage; D004867:Equipment Design; D005260:Female; D006801:Humans; D007267:Injections / Q000295:instrumentation / Q000379:methods; D008012:Lidocaine / Q000008:administration & dosage; D008297:Male; D008442:Maxillary Nerve / Q000187:drug effects; D009061:Mouth Mucosa / Q000294:innervation; D010147:Pain Measurement; D017288:Pain Threshold / Q000187:drug effects; D010159:Palate / Q000294:innervation; D013594:Syringes; D014662:Vasoconstrictor Agents / Q000008:administration & dosage
chemical_list: D000779:Anesthetics, Local; D014662:Vasoconstrictor Agents; D008012:Lidocaine; D004837:Epinephrine