Division of Dental Hygiene, The Ohio State University College of Dentistry, Columbus, Ohio.
Division of Endodontics, The Ohio State University College of Dentistry, Columbus, Ohio.
J Endod. 2020 Nov;46(11):1592-1596. doi: 10.1016/j.joen.2020.07.029. Epub 2020 Aug 5.
When patients express fear and anxiety about dentistry, 1 main source involves the administration of local anesthetic. The Dentapen (Septodont, Lancaster, PA) is a computer-controlled local anesthetic device that regulates the rate of anesthetic deposition to reduce pain associated with dental injections. The purpose of this study was to evaluate differences in perceived pain during the administration of local anesthesia of the maxillary lateral incisors using the ramp-up and continuous injection modes of the Dentapen.
This study used a randomized, controlled, double-blind, crossover, experimental design. The investigators randomly assigned the order of the teeth (#7 or #10) and the 2 delivery modes (continuous or ramp-up). Participants completed a Corah dental anxiety scale at each visit and were injected on 2 separate visits at least 2 weeks apart. After each injection, participants rated their perceived pain using a Heft-Parker visual analog scale at needle insertion, needle placement, and solution deposition. Repeated measures analysis of variance was used to determine differences in perceived pain between the 2 modes.
The data from 116 participants were analyzed. The perceived pain at deposition with the ramp-up mode (mean = 51.98, standard deviation = 30.04) was less than the continuous mode (mean = 59.98, standard deviation = 36.28) although not statistically significant (F = 2.569, P > .05). Clinically, the perceived pain with the ramp-up mode was in the mild range (<54 mm), whereas the mean perceived pain with the continuous mode was in the moderate/severe range (>54 mm).
Further research should evaluate whether the ramp-up mode could be used to reduce the pain perceived with other dental injections.
当患者对牙科治疗感到恐惧和焦虑时，1 个主要来源涉及局部麻醉的管理。Dentapen（Septodont，Lancaster，PA）是一种计算机控制的局部麻醉设备，可调节麻醉剂沉积速度，以减轻与牙科注射相关的疼痛。本研究的目的是评估使用 Dentapen 的升压和连续注射模式在给上颌侧切牙进行局部麻醉时感知到的疼痛差异。
本研究采用随机、对照、双盲、交叉、实验设计。研究者随机分配牙齿（#7 或#10）和 2 种输送模式（连续或升压）的顺序。参与者在每次就诊时完成 Corah 牙科焦虑量表，并在至少 2 周的间隔内进行 2 次单独就诊的注射。每次注射后，参与者使用 Heft-Parker 视觉模拟量表在针插入、针放置和溶液沉积时评估他们的感知疼痛。使用重复测量方差分析来确定 2 种模式之间感知疼痛的差异。
对 116 名参与者的数据进行了分析。升压模式（平均=51.98，标准差=30.04）的沉积时感知疼痛小于连续模式（平均=59.98，标准差=36.28），尽管差异无统计学意义（F=2.569，P>.05）。临床上，升压模式的感知疼痛处于轻度范围（<54mm），而连续模式的平均感知疼痛处于中度/重度范围（>54mm）。
应进一步研究升压模式是否可用于减轻其他牙科注射的疼痛感知。
