Clinical Efficacy and Pain of Computer-Controlled Intraosseous Anesthesia versus the Conventional Inferior Alveolar Nerve Block in Pulpotomy of Primary Molars: A Clinical Trial

Background and Aim: This study assessed the efficacy of intraosseous anesthesia (IA) administered by a computer-controlled local anesthetic device (CCLAD) and its associated pain in comparison with the conventional inferior alveolar nerve block (IANB) for pulpotomy of primary molars. Materials and Methods: This crossover split-mouth randomized controlled clinical trial was conducted on 30 children between 4 and 6 years requiring pulpotomy of mandibular primary molars bilaterally. The children were randomly assigned to two groups to receive IA and IANB in two orders of IA/IANB and IANB/IA within two treatment sessions. Pain during injection and during treatment was quantified subjectively using the Wong-Baker Faces Pain Rating Scale (WBPRS) and objectively using the Face, Legs, Activity, Cry, and Consolability (FLACC) scale. Heart rate (HR) was measured by a pulse oximeter, and the need for supplemental injection was recorded. Data were analyzed using repeated measures ANOVA, Wilcoxon, Mann-Whitney, Bonferroni, Fisher’s exact , and McNemar tests (alpha=0.05). Results: Injection type had no significant effect on the HR in the first or second treatment session, injection pain, procedural pain, FLACC score, or the need for supplemental injection (P>0.05). Within-group comparison of pain in the IA/IANB group showed significantly higher pain associated with IANB (P=0.015), while this difference was not significant in the IANB/IA group (P>0.05). Primary first and second molars had no significant difference in FLACC score or the need for supplemental injection (P>0.05). Conclusion: IA may be used as an alternative to IANB for pulpotomy of primary molars, due to comparable efficacy and injection pain.