Saxena Bhawna, Goswami Mousumi, Saxena Aditya, Padha Sanjesh, Sharma Ananya, Garg Yashika, Singhal Prachi
Department of Paediatric and Preventive Dentistry I.T.S Dental College, Hospital and Research Centre, Greater Noida, Uttar Pradesh, India.
Evid Based Dent. 2025 Jan 8. doi: 10.1038/s41432-024-01094-4.
AIMS/OBJECTIVES: This systematic review aimed to evaluate the effectiveness of auxiliary aids-Transcutaneous Electrical Nerve Stimulation (TENS), vibrotactile devices, and Low-Level Laser Therapy (LLLT) in reducing pain and anxiety during dental local anesthesia in pediatric patients.
The review followed PRISMA guidelines, employing a comprehensive search strategy across multiple databases (PubMed, Cochrane, EBSCO, LILACS, Google Scholar, and Embase) from 2014 to July 2024. Eligibility criteria were based on the PICOS framework, focusing on randomized clinical trials and clinical studies involving pediatric patients undergoing dental procedures with local anesthesia. The interventions included TENS, vibrotactile devices, or LLLT. Pain and anxiety were assessed using validated scales such as the Wong-Baker Faces Pain Rating Scale and physiological measures like heart rate.
Nineteen studies with a total of 1094 pediatric patients aged 4-12 were included. TENS and vibrotactile devices consistently showed significant reductions in pain and anxiety compared to standard methods. LLLT results were more variable, with some studies reporting significant pain reduction while others showed no significant difference. Meta-analysis was not possible due to heterogeneity among the studies. Overall, TENS and vibrotactile devices were more effective in alleviating injection-related pain, especially when combined with cold applications or topical anesthetics.
The findings highlight the potential of these auxillary aids as non-invasive and effective adjuncts for reducing pain and anxiety in pediatric dental procedures. LLLT showed mixed outcomes, likely due to variability in application protocols, suggesting a need for standardized methods. While all interventions demonstrated promise, inconsistencies in study designs and subjective measures limit the generalizability of the results.
TENS and vibrotactile devices are effective auxiliary aids for reducing pain and anxiety during dental local anesthesia in children. Further research is required to optimize LLLT protocols and standardize intervention applications to achieve consistent results across studies.
本系统评价旨在评估辅助工具——经皮电刺激神经疗法（TENS）、振动触觉装置和低强度激光疗法（LLLT）在减轻小儿患者牙科局部麻醉期间疼痛和焦虑方面的有效性。
本评价遵循PRISMA指南，采用全面的检索策略，检索了2014年至2024年7月期间多个数据库（PubMed、Cochrane、EBSCO、LILACS、谷歌学术和Embase）。纳入标准基于PICOS框架，重点关注涉及接受牙科局部麻醉手术的小儿患者的随机临床试验和临床研究。干预措施包括TENS、振动触觉装置或LLLT。使用经过验证的量表（如面部表情疼痛评分量表）和心率等生理指标评估疼痛和焦虑。
纳入了19项研究，共1094名4至12岁的小儿患者。与标准方法相比，TENS和振动触觉装置始终显示出疼痛和焦虑的显著减轻。LLLT的结果更具变异性，一些研究报告疼痛显著减轻，而另一些研究则显示无显著差异。由于研究之间存在异质性，无法进行荟萃分析。总体而言，TENS和振动触觉装置在减轻注射相关疼痛方面更有效，尤其是与冷敷或局部麻醉剂联合使用时。
研究结果突出了这些辅助工具作为减轻小儿牙科手术疼痛和焦虑的非侵入性有效辅助手段的潜力。LLLT显示出混合结果，可能是由于应用方案的变异性，这表明需要标准化方法。虽然所有干预措施都显示出前景，但研究设计和主观测量的不一致性限制了结果的普遍性。
TENS和振动触觉装置是减轻儿童牙科局部麻醉期间疼痛和焦虑的有效辅助工具。需要进一步研究以优化LLLT方案并标准化干预应用，以在各研究中取得一致结果。
