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. 2025 Jan 5;59(1):7-11.
doi: 10.26650/eor.20241409206.

External cold and vibration with BUZZY versus topical anesthetic gel for pain and anxiety associated with infiltrative anesthesia in pediatric dentistry: a double-blinded, split-mouth, randomized, controlled trial

Reyhaneh Faghihian  1 , Mohammad Moin Tofighi  2 , Sanaz Ziaei  2 , Sayed Lotfollah Afzali  2
Affiliations

External cold and vibration with BUZZY versus topical anesthetic gel for pain and anxiety associated with infiltrative anesthesia in pediatric dentistry: a double-blinded, split-mouth, randomized, controlled trial

Reyhaneh Faghihian et al. Eur Oral Res. .

Abstract

Purpose: A way to reduce the pain of injection is applying of external cold or vibrations with BUZZY, along with spinal cord gate control systems. We aimed to evaluate the effectiveness of this method in reducing children's pain and anxiety during infiltrative anesthesia.

Materials and methods: This was a double-blinded, randomized, split-mouth, controlled, trial. Thirty 6 to 12-year-old children with decayed first permanent molar tooth on both sides of their maxilla were enrolled. Each side of the children's mouths was randomly allocated to either BUZZY or topical anesthetic gel prior to infiltrative anesthesia. Pain and anxiety during infiltrative anesthesia were measured with the Baker-Wong (BWS), FLACC (Face, Leg, Activity, Cry, Consolability), and heart rate (HR) scales.

Results: A generalized estimating equation (GEE) adjusted for age and baseline HR, indicated, significantly-lower intra-procedural HRs associated with BUZZY (aOR [95%CI]: 0.02 [0.00, 0.91], p=0.04). GEEs adjusted for age revealed the BWS (aOR [95%CI]: 0.59 [0.30, 1.14], p=0.12) and FLACC (aOR [95%CI]: 0.82 [0.62, 1.09], p=0.17) scores to be comparable between the study arms.

Conclusion: Our study failed to demonstrate the superiority of BUZZY over anesthetic gels regarding WBS and FLACC measures of pain and anxiety, but demonstrated a decrease in HR associated with BUZZY.

Keywords: Pediatric dentistry; behavioral control; dental anxiety; pain; vibration.

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Conflict of interest statement

Conflict of interest:The authors declared that they have no conflict of interest.

Figures

Figure 1.
Figure 1.
BUZZY device and its use in pediatric dentistry. (Images from: dentaquick.com)
Figure 2.
Figure 2.
CONSORT flow diagram
See this image and copyright information in PMC

References

    1. Melzack R, Wall PD. Pain mechanisms: a new theory. Science. 1965. Nov;150(3699):971–9. 10.1126/science.150.3699.971 - DOI - PubMed
    1. Mohiuddin I, Setty JV, Srinivasan I, Desai JA. Topical application of local anaesthetic gel vs ice in pediatric patients for infiltration anaesthesia. J Evol Med Dent Sci. 2015;4(74):12934–41. 10.14260/jemds/2015/1866 - DOI
    1. Nahra H, Plaghki L. Innocuous skin cooling modulates perception and neurophysiological correlates of brief CO2 laser stimuli in humans. Eur J Pain. 2005. Oct;9(5):521–30. 10.1016/j.ejpain.2004.11.007 - DOI - PubMed
    1. Moayedi M, Davis KD. Theories of pain: from specificity to gate control. J Neurophysiol. 2013. Jan;109(1):5–12. 10.1152/jn.00457.2012 - DOI - PubMed
    1. Hegde KM, R N, Srinivasan I, D R MK, Melwani A, Radhakrishna S. Effect of vibration during local anesthesia administration on pain, anxiety, and behavior of pediatric patients aged 6-11 years: A crossover split-mouth study. J Dent Anesth Pain Med. 2019. Jun;19(3):143–9. 10.17245/jdapm.2019.19.3.143 - DOI - PMC - PubMed

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