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Effect of Needle Insertion Angle on Pain During Labial Infiltration Anesthesia of the Anterior Maxilla: A Randomized Clinical Trial Publisher Pubmed



Moaddabi A1 ; Molania T2 ; Arezoumandi A3 ; Ghaedsharaf S4 ; Cernera M5 ; Nikbakht R6 ; Soltani P5, 7 ; Spagnuolo G5 ; Shahnaseri S8
Authors
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Authors Affiliations
  1. 1. Department of Oral and Maxillofacial Surgery, School of Dentistry, Dental Research Center, Mazandaran University of Medical Sciences, Sari, Iran
  2. 2. Department of Oral Medicine, Dental Research Center, Faculty of Dentistry, Mazandaran University of Medical Sciences, Sari, Iran
  3. 3. Students Research Committee, School of Dentistry, Mazandaran University of Medical Sciences, Sari, Iran
  4. 4. Private Practice, Tehran, Iran
  5. 5. Department of Neurosciences, Reproductive and Odontostomatological Sciences, University of Naples “Federico II”, Naples, Italy
  6. 6. Department of Biostatistics and Epidemiology, Faculty of Health, Mazandaran University of Medical Sciences, Sari, Iran
  7. 7. Department of Oral and Maxillofacial Radiology, School of Dentistry, Dental Implants Research Center, Dental Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
  8. 8. Department of Oral and Maxillofacial Surgery, School of Dentistry, Meharry Medical College, Nashville, TN, United States

Source: Clinical and Experimental Dental Research Published:2024


Abstract

Objectives: This study aimed to assess the effect of needle insertion angle on pain during labial infiltration anesthesia in the anterior maxillary region. Material and Methods: In this parallel-design randomized clinical trial, participants were randomly assigned to four groups for labial infiltration anesthesia of the anterior maxilla. Local anesthesia was performed with needle orientation parallel to the longitudinal axis of the tooth using a conventional syringe (Syringe-0), needle at α angle with a conventional syringe (Syringe-α), computer-controlled local anesthetic delivery (CCLAD) device parallel to the longitudinal axis of the tooth (CCLAD-0), and CCLAD at α angle (CCLAD-α). The heart rate (HR), blood pressure (BP), and respiratory rate (RR) of participants were measured before needle insertion, immediately after needle insertion, and immediately after the injection by a vital signs monitor. The level of pain experienced by participants was quantified using a numerical rating scale (NRS). Data were analyzed by repeated-measures ANOVA and regression models (α = 0.05). Results: Thirty-six participants aged from 21 to 60 years, with a mean age of 35.36 years were recruited. The mean pain scores were 7.44, 4.67, 2.89, and 0.67 in groups Syringe-0, Syringe-α, CCLAD-0, and CCLAD-α, respectively (p < 0.001). Age and sex had no significant effect on pain scores (p = 0.914 and p = 0.702, respectively). The four groups had no significant difference in vital signs (p > 0.05). Conclusions: Injection at an α angle and the application of CCLAD can be used in clinical practice to decrease the pain experienced by participants during labial infiltration anesthesia of the anterior maxilla. Trial Registration: Iranian Registry of Clinical Trials: IRCT20230719058849N1. © 2024 The Author(s). Clinical and Experimental Dental Research published by John Wiley & Sons Ltd.
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