Effectiveness of Intraosseous Local Anesthesia (QuickSleeper 5) During Pulpotomy and Stainless Steel Crown Placement on Mandibular Primary Molars: A Crossover Randomized Controlled Clinical Trial.

Abstract

Background: Effective pain management during dental procedures is essential to ensure positive treatment outcomes, particularly for pediatric patients. Intraosseous anesthesia, administered via the QuickSleeper system, has shown promise as an alternative to traditional local anesthesia techniques.

Methods: A single-blinded split-mouth randomized controlled clinical trial took place at the dental hospital at King Saud University with 33 healthy patients (aged 4-9 years), who required pulpotomies and stainless steel crown procedures on two mandibular primary molars, to evaluate the effectiveness of two local anesthetic techniques. Each tooth was randomly assigned to receive 4% articaine either delivered via the intraosseous route using QuickSleeper 5 or buccal infiltration. The effectiveness of the anesthesia was evaluated by the number of injections needed and at various stages using the Sounds, Eyes, and Motor (SEM) scale. Postoperative complications, including pain, swelling, and lip numbness, were assessed through follow-up phone calls with the patients' legal guardians.

Results: The techniques demonstrated comparable effectiveness; there were no statistically significant differences in the number of injections and in the SEM scale scores. Minimal postoperative complications were reported: lip biting (two cases) and prolonged numbness (nine cases) were reported only when buccal infiltration was used, and swelling and pain were reported when both techniques were used.

Conclusions: Intraosseous anesthesia via the QuickSleeper 5 system is comparable to traditional buccal infiltration anesthesia for pulpotomies and stainless steel crown procedures in pediatric mandibular molars. Intraosseous anesthesia offers the added benefit of reduced soft tissue numbness and associated complications.