title: Pain sensation and injection techniques in maxillary dento-alveolar surgery procedures in children--a comparison between conventional and computerized injection techniques (The Wand).
abstract: Local anesthesia, especially palatal injection, is often associated with fear and anxiety. The aim was to compare the sensation of pain when using palatal block technique with computerized injection technique (CIT), to conventional infiltration technique with traditional syringe in surgical procedures involving the palate. Patients referred for bilateral minor maxillary surgical treatments were randomized for traditional infiltration anesthesia on one side and palatal block anesthesia with CIT on the other side. AMSA and P-ASA approaches were used with CIT. The sensation of pain was scored by the VAS scale. Twenty-eight patients were included in the study, where of 17 (61%) were girls. The median age was 14.8 yrs. (12.6 - 17.8). Bilateral exposure of palatal impacted canines was the most common treatment. The injection pain was significantly lower, (p = 0.009), when using the CIT injection compared to conventional injection. However, with time-consuming surgery, additional CIT analgesic solution had to be injected in the buccal gingiva when suturing, in one fourth of the cases. Patients sedated with nitrous oxide seemed to benefit less from CIT. Computerized injection techniques, including P-ASA and AMSA approaches, reduces the sensation of pain when carrying out less time-consuming palatal dental surgery, especially in non-sedated teenagers.
authors.forename: Birgitta
authors.initials: B
authors.lastname: Jälevik
authors.forename: Gunilla
authors.initials: G
authors.lastname: Klingberg
mesh_terms: D000293:Adolescent; D000766:Anesthesia, Dental / Q000295:instrumentation*; D018685:Anesthetics, Inhalation / Q000008:administration & dosage; D000779:Anesthetics, Local / Q000008:administration & dosage*; D001641:Bicuspid / Q000601:surgery; D002648:Child; D016292:Procedural Sedation / Q000379:methods; D003481:Cuspid / Q000601:surgery; D016854:Dental Anxiety / Q000523:psychology; D005260:Female; D006801:Humans; D007267:Injections / Q000009:adverse effects; D008012:Lidocaine / Q000008:administration & dosage; D008297:Male; D009407:Nerve Block / Q000295:instrumentation*; D009609:Nitrous Oxide / Q000008:administration & dosage; D010146:Pain / Q000209:etiology*; D010147:Pain Measurement; D010159:Palate / Q000294:innervation / Q000601:surgery; D013594:Syringes; D013813:Therapy, Computer-Assisted / Q000295:instrumentation*; D014081:Tooth Extraction; D014095:Tooth, Impacted / Q000601:surgery
chemical_list: D018685:Anesthetics, Inhalation; D000779:Anesthetics, Local; D008012:Lidocaine; D009609:Nitrous Oxide