Comparison of computer-controlled intraosseous anaesthesia and conventional anaesthesia in paediatric dentistry: a split-mouth randomised clinical trial

PURPOSE: To compare the efficacy, patient-reported acceptance, and preference of Computer-Controlled Intraosseous Anaesthesia (CCIA) and Conventional Local Anaesthesia (CLA) in paediatric dentistry. METHODS: Healthy children aged 5-9 years who required similar treatment on both sides of either jaw were recruited from a university clinic. In a split-mouth randomised design, children received CCIA and CLA on contralateral sides one week apart, with side and sequence randomly allocated. Both procedures and data collection were performed by a single experienced paediatric dentist, and patient acceptance and preference were assessed using structured questions. Data were analysed with linear/logistic regressions adjusting for within-patient clustering (alpha = 5%). RESULTS: 64 children (mean age 7.0 years; 44% boys) were included. No significant differences in CCIA or CLA clinical efficacy were seen (P = 0.59). Controlled Intraosseous Anaesthesia was associated with significantly less discomfort at needle insertion (Odds Ratio [OR] = 0.32; 95% Confidence Interval (95% CI) 0.16, 0.62), during injection (OR = 0.17; 95% CI 0.08, 0.31), and overall during application (OR = 0,14; 95% CI 0.06, 0.31), as well as with lower fear levels (OR = 0.43; 95% CI 0.22, 0.84) compared to CLA (P < 0.05 in all instances). Although CCIA required longer administration, it produced shorter soft-tissue numbness and less self-inflicted trauma, and was more often associated with unpleasant taste, unusual tooth sensation, and post-injection bruising; nevertheless, CCIA was preferred by more children (78%) than CLA (22%; P < 0.001). CONCLUSIONS: No difference in clinical efficacy between CCIA/CLA was seen; CCIA was associated with reduced procedural pain and fear compared to CLA, resulted in shorter soft tissue numbness, less self-inflicted trauma and was preferred by most children despite longer administration time and more transient local adverse sensations.