Assessment of Needleless Jet Injection in Pain and Anxiety Management during Vital Pulpotomy of Mandibular Primary Molars: A Split-Mouth Randomized-Controlled Clinical Study
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Keywords
Pain, anxiety, pulpotomy, local anesthesia, jet injection and behavioral rating scale and preschool children
Abstract
The purpose of the current study was to compare the effectiveness of needleless jet injection versus traditional inferior alveolar nerve block anesthesia (INAB) in management of pain and anxiety during vital pulpotomy of mandibular second primary molars in children. Methods: A randomized, split-mouth clinical trial was conducted on thirty children aged 4-8 years, who required vital pulpotomies for bilateral carious second mandibular primary molars. The children were divided equally into two main groups, the pre-school age group, before the eruption of lower first permanent molar, while the school age group, after the eruption of lower first permanent molar. Each group was subdivided according to the technique of local anesthesia, INAB subgroup (control side) and needleless jet injection subgroup (examined side), followed by pulpotomy and restored with stainless steel crown. The children's perceptions of pain were evaluated using Wong-Baker FACES Pain Rating Scale. Additionally, anxiety levels of children were evaluated using Venham's anxiety and behavioral rating scale. Results: : According to Wong-Baker FACES Pain Rating Scale, a significant difference between the control (2.67±2.69) and examined subgroups (1.33±0.98) observed in the preschool age group immediately after LA, while in school children age group, there was a highly significant difference between the control (1.47±1.19) and examined subgroups (0.53±0.92). During pulpotomy, results revealed non-significant difference between the control (1.33±0.63) and examined (1.73±0.92) subgroups for preschoolers, while in school children age group, results showed a considerable difference between the control (0.27±0.7) and examined (2.93±3.99) subgroups. On recording Venham's anxiety and behavioral rating scale for preschool children, results showed significant difference between the control (1.27±0.96, 0.73±0.63) and examined (0.73±0.46, 0.87±0.92) subgroups immediately after LA and during pulpotomy, respectively. While in school children, it showed differences with highly significance between the control (0.87±0.6) and examined (0.33±0.5) subgroups, immediately after LA, moreover during pulpotomy, results showed significant difference between the control (0.13±0.4) and examined (1.47±2.0) subgroups for both preschool and school children. Conclusion: Jet injector was effective during pulpotomy of lower second primary molars in preschool children, while it was effective to some extent in school age children
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