Clinical evaluation of different types of injection systems and comparison of pain acceptance in palatal anesthesia in pediatric patients: a randomized controlled split-mouth study.

Background: Local dental anesthesia is the most commonly used method for eliminating pain during dental treatment. Palatal injections, which are routinely used to extract deciduous molars, may be poorly tolerated by pediatric patients. The aim of this study was to evaluate the pain acceptance and anesthetic efficacy of the Comfort-In needle-free injection compared with the traditional injection method in upper deciduous molars requiring extraction.

Methods: Patients between the ages of 4 and 10 years who were admitted to our clinic and required extraction of their maxillary deciduous molars under local anesthesia were included in our study. Infiltration anesthesia with a conventional dental injector was applied to one of the symmetrical teeth, and a Comfort-in jet injection system was applied to the other. The Index of Dental Anxiety and Fear (IDAF-4C) anxiety scale was administered to children. The Wong-Baker Pain Rating Scale (WBPRS) and Face, Legs, Activity, Cry, Consolability (FLACC) scales were applied to the children during the injection. The physiological parameters of the children were evaluated using pulse oximetry. Data were analyzed using IBM SPSS V23 software (SPSS Inc., IBM Co., Somers, NY, USA). The significance level was set at P < 0.050.

Results: No significant difference was observed between Comfort-In jet injection and conventional dental anesthesia in terms of Frankl scores (P = 0.180), pulse rate (P = 0.569), oxygen saturation (P = 0.615), and FLACC total values (P = 0.082). IDAF-4C anxiety levels were low in most of the included children. The categorical distribution of the WBPRS showed a statistically significant difference according to the method used (P = 0.022).

Conclusions: We concluded that the Comfort-In jet injection system is as effective as the gold standard of infiltration anesthesia with a conventional dental syringe and that the Comfort-In jet injection system is acceptable to patients in the postoperative period. Needle-free jet injection is a promising alternative to palatal needle injection for palatal infiltration anesthesia in the maxillary first molars.