Comparative Assessment of Behavior, Anxiety, Pulse Rate, and Pain Perception in Children Using Different Local Anesthesia Delivery Systems: A Randomized Controlled Trial.
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Abstract
Background: Local anesthesia (LA) remains fundamental to effective pain control in invasive dental procedures. However, the act of administering LA can itself be a source of anxiety, particularly among pediatric patients, which may in turn influence their pain perception. Technological advancements, such as computer-controlled LA delivery systems, have emerged as innovative alternatives designed to enhance patient comfort and potentially reduce the pain and anxiety associated with conventional injection techniques.
Aim: To compare and evaluate behavior, anxiety, pulse rate, and pain perception in children using StarPen, VibraJect, and conventional syringe systems.
Materials and methods: In this parallel-group randomized controlled trial, a total of 150 children (aged 6-10 years) undergoing inferior alveolar nerve block (IANB) were randomly divided into three groups (n = 50 each): Group A (StarPen), group B (VibraJect), and group C (conventional syringe). Pain, anxiety, pulse rate, and behavior were evaluated during and after injection using the Face, Legs, Activity, Cry, Consolability (FLACC) scale, Venham's Anxiety Scale (VAS), a pulse oximeter, and Frankl's Behavior Rating Scale (FBRS), respectively.
Results: StarPen demonstrated the most favorable outcomes, significantly reducing pain (mean FLACC: 1.19 ± 0.55), anxiety (mean Venham: 0.58 ± 0.54), and pulse rate (mean: 105.09 ± 4.37 bpm) compared to VibraJect and conventional syringe groups (p < 0.001). Behavioral assessments showed the least post-treatment decline in cooperation with StarPen, suggesting improved procedural tolerance. VibraJect also offered measurable benefits over traditional syringes but was less effective than StarPen.
Conclusion: StarPen demonstrated superior outcomes across all evaluated parameters, supporting its efficacy as a behavior-management tool and pain-minimizing device in pediatric dentistry.
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