Department of Clinical and Translational Medicine, Tor Vergata University of Rome, Rome, Italy.
Department of Surgical Sciences, Catholic University of Our Lady of Good Counsel of Tirane, Tirana, Albania.
Clin Oral Investig. 2018 Dec;22(9):3205-3213. doi: 10.1007/s00784-018-2413-2. Epub 2018 Mar 10.
The aim of the present study was to compare an electronic device, the Wand Injection System (Milestone Scientific Livingstone), with conventional anesthesia in terms of the following: pain sensation during anesthetic injection; effectiveness in achieving adequate anesthesia for a complete painless dental treatment; post-operative discomfort; and patient's anxiety toward dental treatment.
Eighty adults from 18 to 70 years were enrolled in this cross-over study. Each patient served as his/her own control being subject to two anesthesia techniques: conventional and Single Tooth Anesthesia (STA) performed with the Wand. A split-mouth design was adopted in which each tooth undergoing conservative restorative or endodontic treatment received anesthesia with both techniques at 1-week interval. Before anesthetic administration, the patients' anxiety levels were determined. Physiological parameteres were measured before, during, and after the two injection procedures, and the Visual Analogue Scale (VAS) was used to assess pain of injection, discomfort, and anesthetic efficacy. Differences in assessment of pain's injection, discomfort, anesthetic efficacy, vital parameters (heart rate, blood pressure, and oxygen saturation), and state anxiety levels were analyzed using Student's t test (p value < 0.001).
The mean injection pain and post-operative discomfort ratings with Wand were lower than those with conventional syringe (p = 0.022 and p < 0.001, respectively). No differences were found in the assessment of anesthetic efficacy. Blood pressure and heart rate mean values were lower during the anesthesia performed with the Wand than with the conventional syringe (p < 0.001). The anxiety level was higher during the first appointment, independently from the device used for the injections.
The STA technique resulted in lower pain, discomfort, and lower intensity of physiological parameters.
Single Tooth Anesthesia could be an efficacious alternative to conventional procedures.
本研究旨在比较电子设备 Wand 注射系统（Milestone Scientific Livingstone）与传统麻醉在以下方面的差异：麻醉注射时的疼痛感觉；实现完全无痛牙科治疗所需的麻醉效果；术后不适；以及患者对牙科治疗的焦虑。
80 名 18 至 70 岁的成年人参与了这项交叉研究。每位患者均作为自身对照，接受两种麻醉技术：传统麻醉和 Wand 进行的单牙麻醉（STA）。采用劈裂口腔设计，每颗接受保守修复或根管治疗的牙齿在 1 周间隔内接受两种技术的麻醉。在进行麻醉之前，确定患者的焦虑水平。在两次注射过程之前、期间和之后测量生理参数，并使用视觉模拟量表（VAS）评估注射疼痛、不适和麻醉效果。使用学生 t 检验（p 值 < 0.001）分析注射疼痛、不适、麻醉效果、生命体征（心率、血压和血氧饱和度）和状态焦虑水平评估的差异。
与传统注射器相比，Wand 的注射疼痛和术后不适评分平均值较低（p = 0.022 和 p < 0.001）。在评估麻醉效果方面没有差异。在 Wand 麻醉期间，血压和心率的平均值低于传统注射器（p < 0.001）。无论使用哪种设备进行注射，焦虑水平在第一次就诊时均较高。
STA 技术可降低疼痛、不适和生理参数的强度。
单牙麻醉可能是传统程序的有效替代方法。
