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.