Effects of computer-assisted and conventional local anaesthesia on pain and anxiety in children with molar incisor hypomineralisation: a randomized controlled clinical trial

BACKGROUND: This prospective study aimed to comparatively investigate the effects of conventional mandibular anaesthesia and digital mandibular and intraosseous anaesthesia administered using the computer-assisted local anaesthesia device (SleeperOne 5) on pain and anxiety in paediatric patients with molar incisor hypomineralisation (MIH), using physiological, projective, psychometric, and biological parameters. METHODS: Sixty-nine paediatric patients aged 7-12 years with a diagnosis of MIH were allocated to three groups receiving conventional mandibular anaesthesia, computer-assisted digital mandibular anaesthesia, and intraosseous anaesthesia techniques. Physiological parameters, including pulse rate and oxygen saturation, were assessed before, during, and after anaesthesia. Projective parameters, including the Visual Analogue Scale (VAS) and Wong-Baker FACES Scale (WBS), psychometric parameters, including the Facial Image Scale (FIS), Face, Legs, Activity, Cry, Consolability scale (FLACC), and Modified Child Dental Anxiety Scale (MCDAS) together with biological marker levels represented by salivary opiorphin, were evaluated before and after anaesthesia. Data analysis was performed using the licensed IBM Statistical Package for the Social Sciences Version 21 software. RESULTS: Across all anaesthesia techniques, pulse rate increased during anaesthesia; however, no significant differences were observed in pulse or oxygen saturation changes among the groups (p > 0.05). Pain and anxiety levels showed significantly lower values with computer-assisted mandibular anaesthesia and intraosseous anaesthesia when compared to the conventional technique. A significant reduction in salivary opiorphin levels was observed after anaesthesia, with the greatest reduction recorded in the intraosseous anaesthesia group (p < 0.05). CONCLUSIONS: Digital anaesthesia techniques represent a comfortable and safe alternative for reducing pain and anxiety in paediatric patients with MIH. In particular, intraosseous anaesthesia demonstrated an effective role in reducing stress responses. TRIAL REGISTRATION: TCTR identification number: TCTR20241120001; registered on 20 November 2024. The trial was registered prospectively.