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Pain and anxiety associated with Computer-Controlled Local Anaesthesia: systematic review and meta-analysis of cross-over studies
Pubblication date: 12/2018
Authors: A. Libonati*, R. Nardi**, G. Gallusi**, V. Angotti**, S. Caruso***, F. Coniglione*, G. Marzo***, A. Mattei***, S. Tecco****, L. Paglia*****, V. Campanella**
Institution: *Department of Surgical Sciences, Dental School, Catholic University of Our Lady of Good Counsel of Tirane, Tirane, Albania
**Department of Clinical and Translational Medicine, Dental School, University of Rome “Tor Vergata”, Rome, Italy
***Department of Life, Health and Environmental Sciences, Dental School, University of L’Aquila, L’Aquila, Italy
**** Dental School “Vita-Salute San Raffaele” University, Milan, Italy
*****Department of Paediatric Dentistry, Istituto Stomatologico Italiano (ISI), Milan, Italy
Publication: European Journal of Paediatic Dentistry
Title: Pain and anxiety associated with Computer-Controlled Local Anaesthesia: systematic review and meta-analysis of cross-over studies
Abstract: Aim This review focuses on Computer-Controlled Local Anaesthesia Delivery systems (CCLAD), in comparison with conventional carpule anaesthesia in means of pain and anxiety.
Methods Medline, Embase, Web of Science and Cochrane Database for Systematic Reviews were searched up to August 2018. Only cross-over split-mouth design studies aimed to clinically compare CCLAD with a conventional carpule anaesthesia are included. Data about pain and anxiety associated with anaesthesia were sought. The authors performed meta-analysis where appropriate.
Results A total of 20 studies are included in the systematic review (n = 973 subjects). Quantitative synthesis (conducted on VAS scores from 8 studies) shows that pain intensity is over 9 points lower in CCLAD than in conventional anaesthesia on a scale from 0 to 100 (95% confidence interval, −12.90 to −5,53; P<.001). The systematic review showed no differences between the two techniques according to the physiological parameters of pain (heart rate or blood pressure), and the data about anxiety are inconsistent.
Conclusion CCLAD results in significantly slightly less pain perception with respect to conventional injection and is a promising device to help patients. The literature needs to be expanded, mostly regarding anxiety.