Evaluation of block anaesthesia in comparison to intraosseous computerised injection system (Quick Sleeper) in children undergoing dental treatment

Abstract

Local anaesthesia is frequently indicated in paediatric oral healthcare [1]. Two types of anaesthesia exist: conventional intra-mucosal infiltration anaesthesia (CIA), frequently used by practitioners, and intraosseous anaesthesia (IOA), which delivers the local anesthetic within the spongy bone adjacent to the tooth to anesthetize. Needle- and injection-related fears are common sources of dental anxiety in children in case of CIA. Indeed, the needle is not only visible, but also injecting too quickly in the mucosa can lead to pain or discomfort. With IOA, the fear of the needle would be decreased because the pen grip is very close to the needle. Also, pain during injection would be decreased because IOA can be delivered by a computerized system (QuickSleeper™ system), which delivers local anaesthesia at a constant rate and
pressure. Indeed, some authors showed that 83,9% of 50 children felt no pain or only mild discomfort with
QuickSleeper™ system (scores 0 to 2 on the visual analogue scale [VAS]) [2], and that 69,7% of 30
patients preferred IOA compared to CIA [3]. To our best knowledge, IOA studies of pain felt by children have been only observational or non randomized comparative studies. Moreover, a recent systematic review and Evidence-Based Clinical Practice Guidelines showed insufficient evidence supporting the injection technique as superior to others and concluded that more rigorous and high-quality studies are needed