Comparative Evaluation of Pain Assessment Using Star Pen and Conventional Injection Technique during Inferior Alveolar Nerve Block Injection in Children Aged between 6 and 10 Years: A Randomized Controlled Trial.
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Abstract
Background: Managing pain and anxiety during dental procedures is a major concern in pediatric dentistry. The method of local anesthetic delivery significantly influences a child's dental experience. Inferior alveolar nerve block (IANB) is commonly associated with discomfort and anxiety in pediatric patients.
Aim: To compare the efficacy, patient perception, and physiological response of a computer-controlled local anesthetic delivery (CCLAD) system (Woodpecker Star Pen) with a conventional syringe during IANB administration in children aged 6-10 years.
Materials and methods: A randomized, split-mouth crossover trial was conducted on 50 cooperative children requiring bilateral IANB. Each participant received both injection techniques (Star Pen and conventional syringe) in two separate appointments. Pain perception, behavior [sound-eye-motor (SEM) scale], heart rate changes, and injection duration were recorded and analyzed.
Results: The Star Pen significantly reduced pain scores (1.44 ± 1.82) compared to the conventional syringe (3.24 ± 1.94) (p < 0.001). SEM scores were lower for the Star Pen (4.02 ± 1.23) than the conventional syringe (5.59 ± 2.18) (p < 0.001). A significant increase in heart rate was observed with the conventional syringe (p = 0.001), while the Star Pen showed no such effect (p = 0.527). Injection duration was longer with the Star Pen (p < 0.001).
Conclusion: The Woodpecker Star Pen CCLAD system provides a more comfortable and less distressing experience for children compared to the conventional syringe, making it a favorable alternative for delivering IANB in pediatric dental settings.
How to cite this article: Kelkar SM, Shah PP, Chaudhary SM, et al. Comparative Evaluation of Pain Assessment Using Star Pen and Conventional Injection Technique during Inferior Alveolar Nerve Block Injection in Children Aged between 6 and 10 Years: A Randomized Controlled Trial. Int J Clin Pediatr Dent 2026;19(8):980-986.
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