Min Kyung Hyuk, Morse Zac
Department of Oral Health, School of Clinical Sciences, Auckland University of Technology, Auckland, New Zealand.
J Dent Anesth Pain Med. 2024 Jun;24(3):161-171. doi: 10.17245/jdapm.2024.24.3.161. Epub 2024 May 27.
The efficient management of pain and discomfort is essential for successful dental treatment and patient compliance. Dental professionals are commonly evaluated for their ability to perform treatment with minimal patient discomfort. Despite advancements in traditional local dental anesthesia techniques, the pain and discomfort associated with injections remain a concern. This scoping review aims to provide a comprehensive overview of the literature on novel dental anesthetics and associated devices designed to alleviate pain and discomfort during dental procedures. The Joanna Briggs Institute and the Preferred Reporting Items for Systematic reviews and Meta-Analyses Extension for Scoping Reviews guidelines were used to prepare the review. Six databases and two sources of gray literature were searched. This review analyzed 107 sources from 1994 to 2023. Local anesthesia devices were grouped into computer-controlled local anesthetic delivery (CCLAD) systems, intraosseous anesthesia (IOA), vibratory stimulation devices, and electronic dental anesthesia (EDA). CCLAD systems, particularly the Wand and Single-Tooth Anesthesia, have been the most researched, with mixed results regarding their effectiveness in reducing pain during needle insertion compared to traditional syringes. However, CCLAD systems often demonstrated efficacy in reducing pain during anesthetic deposition, especially during palatal injections. Limited studies on IOA devices have reported effective pain alleviation. Vibrating devices have shown inconsistent results in terms of pain reduction, with some studies suggesting their primary benefit is during needle insertion rather than during the administration phase. EDA devices are effective in reducing discomfort but have found limited applicability. These findings suggest that the CCLAD systems reduce injection pain and discomfort. However, the evidence for other devices is limited and inconsistent. The development and research of innovative technologies for reducing dental pain and anxiety provides opportunities for interdisciplinary collaboration and improved patient care in dental practice.
有效管理疼痛和不适对于成功的牙科治疗及患者配合至关重要。牙科专业人员通常会根据其在使患者不适最小化的情况下进行治疗的能力来接受评估。尽管传统局部牙科麻醉技术有所进步,但与注射相关的疼痛和不适仍是一个问题。本综述旨在全面概述有关新型牙科麻醉剂及旨在减轻牙科手术过程中疼痛和不适的相关设备的文献。本综述依据乔安娜·布里格斯研究所及《系统评价和Meta分析扩展版范围综述的首选报告项目》指南编写。检索了六个数据库和两个灰色文献来源。本综述分析了1994年至2023年的107篇文献。局部麻醉设备分为计算机控制局部麻醉给药(CCLAD)系统、骨内麻醉(IOA)、振动刺激设备和电子牙科麻醉(EDA)。CCLAD系统,尤其是The Wand和单牙麻醉系统,研究最多,与传统注射器相比,其在减少进针时疼痛方面的效果不一。然而,CCLAD系统在减少麻醉剂注射过程中的疼痛方面通常显示出疗效,尤其是在上颌注射时。关于IOA设备的研究有限,报告显示其能有效减轻疼痛。振动设备在减轻疼痛方面的结果不一致,一些研究表明其主要益处在于进针时而非给药阶段。EDA设备在减轻不适方面有效,但适用性有限。这些发现表明CCLAD系统可减少注射疼痛和不适。然而,其他设备的证据有限且不一致。减少牙科疼痛和焦虑的创新技术的开发和研究为牙科实践中的跨学科合作及改善患者护理提供了机会。