Citation Information :
Verma R. A Comparative Study to Evaluate Pain Perception in Children Using Comfort Control Injection System and Insulin Syringe: An in Vivo Study. J South Asian Assoc Pediatr Dent 2021; 4 (3):165-168.
Pain during dental procedure has a profound effect on the behavior of children. The comfort controll injection system is a compact, portable design that injects the LA solution with constant speed and pressure control. Insulin syringe needles are short and very thin that are made to lesser discomfort during LA administration.
Aim: To evaluate the pain perception while administering bilateral mandibular local infiltration, in children undergoing dental procedures, by using comfort controll injection and insulin syringe.
Material and methods: Children between 5 and 9 years of age requiring local anesthesia on both sides of arch for various dental procedures were divided into 2 Groups: Group A, comfort controll injection system and Group B, insulin syringe. The mandibular local infiltration was administered using comfort control device on the left side and the insulin syringe on the opposite side at the first appointment and subsequent appointment respectively. Prior, during and after the procedure, the heart rate and saturated oxygen rate were measured using pulse oximeter and FLACC (Face, Legs, Activity, Cry and Consolability) and MCDAS (modified child dental anxiety) were recorded.
Result: The statistical analysis showed non-significant difference in the mean of heart rate before and after local infiltration, whether significant difference seen during local infiltration. Highly non-significant difference of mean values of SpO2 and highly significant difference of mean value of FLACC scale was observed before, during and after local infiltration. The mean of MCDAS scale, during and after local infiltration showed significant difference whether non-significant difference seen before local infiltration.
Conclusion: Comfort control device is introduced several years back and best alternative to other syringe system still it did not get popularity. It is important for clinicians to be familiar with these devices for dental procedures to best explore them.
Kour G, Masih U, Singh C, et al. Insulin syringe: a gimmick in pediatric dentistry. Int J Clin Pediatr Dent 2017;10(4):319–323. DOI: 10.5005/jp-journals-10005-1458
Janani K, Santhosh Kumar MP. Comparison of pain perception with conventional syringe and insulin syringe during greater palatine nerve block. Drug Invent Today 2018;10(7).
Langthasa M, Yeluri R, Jain AA, et al. Comparison of the pain perception in children using comfort control syringe and a conventional injection technique during pediatric dental procedures. J Indian Soc Pedod Prev Dent 2012(Oct–Dec);30 (4):323–328. DOI: 10.4103/0970-4388.108931
Turner S, Chambers SA, Freeman R. Measuring dental anxiety in children with complex and additional support needs using the Modified Child Dental Anxiety Scale (faces) (MCDASf). Int J Dent Oral Heath 2012;13(1):3–10. DOI: 10.4483/JDOH_001Turner08
Nilsson S, Finnström B, Kokinsky E. The FLACC behavioral scale for procedural pain assessment in children aged 5–16 years. Paediatr Anaesth 2008(Aug);(8):767–774. DOI: 10.1111/j.1460-9592.2008.02655.x
Crellin DJ, Harrison D, Hutchinson A, et al. Procedural Pain Scale Evaluation (PROPoSE) study: protocol for an evaluation of the psychometric properties of behavioral pain scales for the assessment of procedural pain in infants and children aged 6–42 months. BMJ Open 2017(Sep 6);7(9):e016225. DOI: 10.1136/bmjopen-2017-016225
Crellin DJ, Harrison D, Santamaria N, et al. Systematic review of the face, legs, activity, cry and consolability scale for assessing pain in infants and children: is it reliable, valid, and feasible for use? Pain. 2015 (Nov);156(11):2132–2151. DOI: 10.1097/j.pain.0000000000000305
Malamed SF. Handbook of Local Anesthesia. 4th ed. St Louis (MO): CV Mosby. 1997.
Ghasemi D, Rajaei S, Aghasizadeh E. Comparison of inferior dental nerve block injections in child patients using 30-gauge and 27-gauge short needles. J Dent Mater Tech 2014 (June);3 (2):71–76. DOI: 10.22038/JDMT.2014.2382
Asokan A. A pain perception comparison of intraoral dental anesthesia with 26 and 30 gauge needles in 6–12-year-old children. J Pediatr Dent 2014;2(2):56–60. DOI: 10.4103/2321-6646.137690
Fuller NP, Menke RA, Meyers WJ. Perception of pain to three different intraoral penetrations of needles. J Am D ent Assoc 1979;(Nov);99(5):822–824. DOI: 10.14219/jada.archive.1979.0384
Lehtinen R. Penetration of 27- and 30-gauge dental needles. Int J Oral Surg 1983(Dec);12(6):444-445. DOI: 10.1016/s0300-9785(83)80036-2
San Martin-Lopez AL, Garrigos-Esparza LD, Torre-Delgadillo G, et al. Clinical comparison of pain perception rates between computerized local anesthesia and conventional syringe in pediatric patients. J Clin Pediatr Dent 2005;29:239–243. DOI: 10.17796/jcpd.29.3.jgh607l870051882
Deepak V, Challa RR, Kamatham R, et al. Comparison of a new auto-controll injection system with traditional syringe for mandibular infiltrations in children: a randomized clinical trial. Anesth Essays Res 2017;11(2):431–438. DOI: 10.4103/0259-1162.194535
Gibson RS, Allen K, Hutfless S, et al. The Wand vs. traditional injection: a comparison of pain related behaviors. Pediatr Dent 2000(Nov–Dec);22(6):458–462. PMID: 11132503.
Tahmassebi JF, Nikolaou M, Duggal MS. A comparison of pain and anxiety associated with the administration of maxillary local analgesia with Wand and conventional technique. Eur Arch Paediatr Dent 2009(June);10(2):77–82. DOI: 10.1007/BF03321604