Padminee, Krishnan
(Department of Pedodontics, SRM Dental College and Hospital)
,
Hemalatha, R
(Department of Pedodontics, SRM Dental College and Hospital)
,
Shankar, P
(Department of Pedodontics, SRM Dental College and Hospital)
,
Senthil, D
(Department of Pedodontics, SRM Dental College and Hospital)
,
Trophimus, Gnanabagyan J
(Department of Pedodontics, SRM Dental College and Hospital)
Background: Placement of full-coverage restorations such as stainless steel crowns (SSCs) for pulpectomy treated primary molars is essential for successful outcomes. The tooth preparation process for SSCs can cause discomfort to gingival tissues since the crown should be seated 1 mm subgingivally. T...
Background: Placement of full-coverage restorations such as stainless steel crowns (SSCs) for pulpectomy treated primary molars is essential for successful outcomes. The tooth preparation process for SSCs can cause discomfort to gingival tissues since the crown should be seated 1 mm subgingivally. The purpose of this prospective trial was to compare the effectiveness of subgingival and transmucosal application of topical anesthetics on dental pain during SSC tooth preparation among 6- to 8-year-old children. Methods: A consecutive sample of 27 children, aged 6-8 years, who required an SSC after pulp therapy in primary molars were randomly divided into three groups. Group A received infiltration anesthesia before tooth preparation for SSC placement, whereas in Group B and C, only topical anesthesia was applied subgingivally and transmucosally. Wong-Bakers Faces pain rating scale (WBFPS) scores were recorded after tooth preparation. Faces, Legs, Activity, Cry and Consolability (FLACC) scores were evaluated by two blinded and calibrated investigators through video recordings of the patient during tooth preparation. Data were tabulated, and inter-group comparisons were performed using the Kruskal-Wallis and analysis of variance tests. Results: Out of the 27 participants, 48% were boys and 52% were girls, with an overall mean age of 6.83 years. Group A showed the least pain scores according to both the scales, followed by Group B and Group C. The pain intensity was statistically significant on both the pain scales with P = 0.003 for FLACC and P < 0.001 for WBFPS. Conclusion: Subgingival application of topical anesthesia reduced pain to a certain extent but not as effectively as infiltration anesthesia during SSC tooth preparation in primary molars. Transmucosal application of topical anesthesia did not reduce discomfort when compared to the other two interventions.
Background: Placement of full-coverage restorations such as stainless steel crowns (SSCs) for pulpectomy treated primary molars is essential for successful outcomes. The tooth preparation process for SSCs can cause discomfort to gingival tissues since the crown should be seated 1 mm subgingivally. The purpose of this prospective trial was to compare the effectiveness of subgingival and transmucosal application of topical anesthetics on dental pain during SSC tooth preparation among 6- to 8-year-old children. Methods: A consecutive sample of 27 children, aged 6-8 years, who required an SSC after pulp therapy in primary molars were randomly divided into three groups. Group A received infiltration anesthesia before tooth preparation for SSC placement, whereas in Group B and C, only topical anesthesia was applied subgingivally and transmucosally. Wong-Bakers Faces pain rating scale (WBFPS) scores were recorded after tooth preparation. Faces, Legs, Activity, Cry and Consolability (FLACC) scores were evaluated by two blinded and calibrated investigators through video recordings of the patient during tooth preparation. Data were tabulated, and inter-group comparisons were performed using the Kruskal-Wallis and analysis of variance tests. Results: Out of the 27 participants, 48% were boys and 52% were girls, with an overall mean age of 6.83 years. Group A showed the least pain scores according to both the scales, followed by Group B and Group C. The pain intensity was statistically significant on both the pain scales with P = 0.003 for FLACC and P < 0.001 for WBFPS. Conclusion: Subgingival application of topical anesthesia reduced pain to a certain extent but not as effectively as infiltration anesthesia during SSC tooth preparation in primary molars. Transmucosal application of topical anesthesia did not reduce discomfort when compared to the other two interventions.
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제안 방법
The children were randomly divided into three groups using the lottery method, and each group was assigned an intervention again through the lottery system.
The time taken and the rate of intervention and tooth preparation were monitored using a digital stopwatch on a smartphone (Apple iPhone 7 plus, Apple Pioneer Place, Portland, Oregon, USA) by a separate investigator.
This pilot study was designed as a randomized controlled trial with three parallel arms to compare the subgingival and transmucosal application of a topical anesthetic using infiltration anesthesia in 6 to 8-year-old children requiring SSC tooth preparation. The study was conducted from December 2019 to January 2020.
The tooth preparation was video recorded using a smartphone (Apple iPhone 7 plus, Apple Pioneer Place, Portland, Oregon, USA) with good quality audio and video facility. This video was evaluated by a single-blinded reviewer (KS) for providing FLACC scores.
대상 데이터
No allergic reactions or untoward effects were observed. A total of 27 children, aged 6-8 years, participated in this pilot study. Fig.
After procuring approval and ethical clearance from the institutional review board (SRMU/M&HS/SRMDC/2020/PG/020), 27 healthy children, aged 6-8 years, were recruited by consecutive sampling.
This pilot study was designed as a randomized controlled trial with three parallel arms to compare the subgingival and transmucosal application of a topical anesthetic using infiltration anesthesia in 6 to 8-year-old children requiring SSC tooth preparation. The study was conducted from December 2019 to January 2020. The sample source was outpatients reporting to the institution’s department of pediatric and preventive dentistry.
데이터처리
The mean pain score according to the WBFP scale was higher in Group C followed by Group B and A with a statistically significant P value (P < 0.001) in the Kruskal-Wallis and ANOVA tests.
이론/모형
The children were randomly divided into three groups using the lottery method, and each group was assigned an intervention again through the lottery system. Each participant was assigned a registration number, and simple randomization into three groups was performed using the fishbowl method. Group A received infiltration anesthesia before tooth preparation, whereas Groups B and C received subgingival and transmucosal application of a topical anesthetic, respectively.
성능/효과
Statistical tests in this study revealed that subgingival anesthetic delivery offered more pain reduction than transmucosal delivery according to both WBFPS (P < 0.001) and FLACC scores (P = 0.003).
후속연구
However, both these methods of delivering topical anesthesia are not as effective in reducing dental pain when compared with infiltration anesthesia. Conducting this study on a larger sample with more sophisticated armamentarium will pave the way for future research leading to better clinical practice.
Secondly, the sample size was too small and inadequate to generalize the results obtained. This study was conducted as a pilot study, and further studies with a larger sample size are needed. Thirdly, the compared drug was different for the control arm and the intervention arms.
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